外阴癌患者发生腹股沟淋巴结转移的影响因素分析

Analysis of factors influencing inguinal lymph node metastasis in vulvar cancer

目的探讨外阴癌患者发生腹股沟淋巴结转移的影响因素。方法收集75例外阴癌患者的临床资料,包括年龄、绝经情况、肿瘤部位类型、肿瘤直径分期等临床特征,对外阴癌患者发生腹股沟淋巴结转移的影响因素进行分析。结果75例外阴癌患者的年龄为32~80岁,中位年龄为59岁,以绝经者居多,肿瘤部位类型以侧位型多见,肿瘤直径为0.6~8.0cm,以外阴鳞状细胞癌最常见,多数为高分化外阴癌,术后淋巴结转移率为62.7%。单因素分析结果显示,肿瘤直径﹥2cm、肿瘤部位类型为中线型、分化程度为中低分化的外阴癌患者的腹股沟淋巴结转移率均高于肿瘤直径≤2cm、肿瘤部位类型为侧位型、病理分化程度为高分化的外阴癌患者(P﹤0.05);不同年龄、绝经情况、病理类型外阴癌患者的淋巴结转移率比较,差异均无统计学意义(P﹥0.05)。多因素分析结果显示,肿瘤直径、肿瘤部位类型是影响外阴癌患者发生腹股沟淋巴结转移的独立影响因素(P﹤0.05)。结论肿瘤直径、肿瘤部位类型是影响外阴癌患者发生腹股沟淋巴结转移的独立影响因素,外阴癌腹股沟淋巴结转移也可能与患者的肿瘤分化程度有关。

Objective To explore the factors influencing inguinal lymph node metastasis in vulvar cancer. Method Clinical data of 75 patients with vulvar cancer were collected, and the influencing factors of inguinal lymph node metastasis in vulvar cancer patients were analyzed. Result In the 75 cases aged 32~80 years old, the median age was 59 years old, most of them were post-menopausal;as to the tumor location, lateral type was the most common ones, with tumor diameter ranging from 0.6 to 8.0 cm, and the majority were vulvar squamous cell carcinoma, which were mainly with high differentiation, the postoperative lymph node metastasis rate was 62.7%. Univariate analysis indicated that, tumor diameter >2 cm, midline type, poor to moderate differentiation were associated with higher inguinal lymph node metastasis compared to tumor diameter ≤2 cm, lateral type, and high differentiation in vulvar cancer patients (P<0.05), and the lymph node metastasis rate was not related to age, menopausal status and pathological type in vulvar cancer patients (P> 0.05). Multivariate analysis indicated that, tumor size and tumor location were independent risk factors for inguinal lymph node metastasis among vulvar cancer patients (P<0.05). Conclusion Tumor diameter and location are independent influence factors for the occurrence of inguinal lymph node metastasis in patients with vulvar cancer, which may also be related to the degree of differentiation.