摘要
目的:探讨早期子宫颈腺癌盆腔淋巴结转移高危因素,为临床是否切除盆腔淋巴结提供参考。方法:收集418例早期子宫颈腺癌患者临床病理资料,进行单因素及多因素Logistic回归分析盆腔淋巴结转移的高危因素。结果:患者发病年龄18~69岁,孕次0~11次,产次0~5次,体质量指数15.15~32.42 kg/m^2。临床表现以接触性出血及阴道不规则流血多见,分别占43.78%(183/418)及31.10%(130/418)。临床分期以ⅠB1期为主,有244例(58.37%);组织学类型以子宫颈腺癌普通型为主,有219例(52.39%)。患者盆腔淋巴结转移率为17.46%(73/418)。单因素分析发现术前未行新辅助化疗、临床分期、组织学类型、肿瘤直径、子宫颈间质浸润深度、淋巴脉管间隙浸润、宫旁浸润、切缘浸润、阴道浸润、宫体浸润、输卵管转移是盆腔淋巴结转移的影响因素(P<0.05)。多因素Logistic回归分析发现,FIGO临床分期Ⅱ期(OR 3.658,95%CI 1.950~6.680)、子宫颈间质浸润深度≥1/2(OR 4.962,95%CI 2.110~11.669)、淋巴脉管间隙浸润(OR 2.279,95%CI 1.190~4.363)、宫体浸润(OR 2.124,95%CI 1.115~4.047)、输卵管转移(OR 6.429,95%CI 1.473~28.063)是盆腔淋巴结转移的高危因素(P<0.05)。结论:早期子宫颈腺癌患者中,FIGO临床分期Ⅱ期、子宫颈间质浸润深度≥1/2、淋巴脉管间隙浸润、宫体浸润、输卵管转移的子宫颈腺癌患者发生盆腔淋巴结转移可能性大,应行盆腔淋巴结切除术。
Objective:To explore the high-risk factors of pelvic lymph node metastasis in early stage cervical adenocarcinoma patients,and to provide reference for clinical resection of pelvic lymph nodes.Methods:The clinicopathological data of 418 patients with early stage cervical adenocarcinoma were collected.The high-risk factors of pelvic lymph node metastasis were analyzed by univariate and logistic regression analysis.Results:The age of the patients ranged from 18 to 69 years old with the number of pregnancies ranged from 0 to 11 and births ranged from 0 to 5,and the body mass index ranged from 15.15 to 32.42 kg/m^2.Contact hemorrhage(43.78%,183/148)and irregular vaginal bleeding(31.10%,130/148)were the most common clinical manifestations,and the numbers were 183 and 130 cases respectively.The clinical stage was mainlyⅠB1,with 244 cases(58.37%)and the histological type was mainly endocervical adenocarcinomausual type,with 219 cases(52.39%).The rate of pelvic lymph node metastasis was 17.46%(73/418).Univariate analysis showed that without neoadjuvant chemotherapy,clinical stage,histological type,tumor diameter,cervical interstitial infiltration,lymphatic vessel space infiltration,parametrial infiltration,margin of incision infiltration,vaginal infiltration,uterine body infiltration and fallopian tube metastasis were the high-risk factors for pelvic lymph node metastasis(P<0.05).Multivariate logistic regression analysis showed that FIGO stageⅡ(OR 3.658,95%CI 1.950-6.680),cervical interstitial infiltration(≥1/2)(OR 4.962,95%CI 2.110-11.669),lymphatic vessel space infiltration(OR 2.279,95%CI 1.190-4.363),uterine body infiltration(OR 2.124,95%CI 1.115-4.047)and fallopian tube metastasis(OR 6.429,95%CI 1.473-28.063)were independent high-risk factors for pelvic lymph node metastasis(P<0.05).Conclusions:Cervical adenocarcinoma patients with FIGO stageⅡ,cervical interstitial infiltration(≥1/2),lymphatic vessel space infiltration,uterine body infiltration and fallopian tube metastasis were more likely to have pelvic lymph node metastasis,and pelvic lymphadenectomy should be performed.
作者
易启华
陈琳
郑莹
陈思敬
徐流凤
董诗萌
YI Qihua;CHEN Lin;ZHENG Ying(Department of Gynecology,West China Second University Hospital,Chengdu Sichuan 610041,China;Department of Gynecology,Chongqing University Three Gorges Hospital,Chongqing 404100,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2020年第8期606-609,共4页
Journal of Practical Obstetrics and Gynecology
关键词
早期子宫颈腺癌
临床病理特征
盆腔淋巴结转移
高危因素
Early stage cervical adenocarcinoma
Clinicopathological characteristics
Pelvic lymph node metastasis
High-risk factors