334例早期宫颈癌腹主动脉旁淋巴结转移的危险因素分析

Analysis of Risk Factors of Para-aortic Lymph Node Metastasis in 334 Cases of Early Stage Cervical Cancer

目的分析研究334例ⅠB～ⅡA期宫颈癌腹主动脉旁淋巴结转移的相关危险因素。方法回顾性分析334例行宫颈癌根治术并行腹主动脉旁淋巴结切除术的ⅠB～ⅡA期宫颈癌患者的临床病理资料,对腹主动脉旁淋巴结转移的相关危险因素进行统计学分析。结果 334例宫颈癌患者中,27例(8.08%)发生腹主动脉旁淋巴结转移。单因素分析显示,分期、术前SCC水平、肌层浸润深度、颈管受侵、脉管瘤栓、神经侵犯、宫体受侵、髂总淋巴结转移、盆腔淋巴结转移个数与腹主动脉旁淋巴结转移有关,而Logistic回归多因素分析显示,宫体受侵、髂总淋巴结转移及盆腔淋巴结转移个数为腹主动脉旁淋巴结转移的独立危险因素。结论宫体受侵、髂总淋巴结转移及盆腔淋巴结转移个数是ⅠB～ⅡA期宫颈癌腹主动脉旁淋巴结转移的独立危险因素,充分评估这些危险因素,有助于判断疾病预后,并为个体化治疗提供依据。

Objective To analyze the related risk factors of para-aortic lymph node metastasis in 334 cases of stageⅠB-ⅡA cervical cancer.Methods The clinical and pathological data of 334 patients withⅠB-ⅡA cervical cancer who underwent radical hysterectomy and para-aortic lymph node dissection were retrospectively analyzed.The relative risk factors of para-aortic lymph node metastasis were statistically analyzed.Results Among the 334 patients with cervical cancer,27(8.08%)had para-aortic lymph node metastasis.Univariate analysis showed that the stage,the preoperative SCC level,the depth of myometrial invasion,the cervical canal invasion,the vessel invasion,the nerve invasion,the uterine body invasion,the common iliac lymph node metastasis,the number of pelvic lymph node metastasis were associated with para-aortic lymph node metastasis.While the multivariate logistic regression analysis showed that the uterine body invasion,the common iliac lymph node metastasis and the number of pelvic lymph node metastasis were independent risk factors of para-aortic lymph node metastasis.Conclusion The uterine body invasion,the common iliac lymph node metastasis and the number of pelvic lymph node metastasis were independent risk factors of para-aortic lymph node metastasisnumber inⅠB-ⅡA cervical cancer.Assessment of these risk factors will help judge the prognosis of the disease and provide the basis for individualized treatment.