伴有淋巴结转移的宫颈癌患者预后的影响因素分析

An analysis of factors influencing the prognosis of cervical cancer patients with lymph node metastasis

目的探讨伴有淋巴结转移的宫颈癌患者预后的影响因素。方法回顾性分析93例伴有淋巴结转移的宫颈癌患者的临床资料,采用Kaplan-Meier生存曲线和Cox回归模型分析影响患者预后的独立危险因素。结果患者年龄、国际妇产科联盟分期、肿瘤分化程度、间质浸润深度、肿瘤直径、脉管内瘤栓、宫旁浸润、淋巴结清扫数目与术后累积复发率和生存率不存在明显相关关系(P>0.05);肿瘤病理类型与术后累积复发率相关(P<0.05),淋巴结转移数目、淋巴结转移率与术后累积复发率和生存率均相关(P<0.05)。非鳞癌和淋巴结转移率>7.3%是影响患者术后疾病复发的独立危险因素(HR=3.429、2.549,P<0.05),淋巴结转移率>7.3%是影响患者术后生存的独立危险因素(HR=3.000,P<0.05)。结论较高的淋巴结转移率是影响伴有淋巴结转移的宫颈癌患者预后的独立危险因素,尤其对淋巴结转移率>7.3%的患者应加强术后补充治疗及随访的管理。

Objective To investigate the factors influencing the prognosis of cervical cancer patients with lymph node metastasis.Methods The clinical data of cervical cancer patients with lymph node metastasis were retrospectively analyzed.The independent risk factors influencing the prognosis of patients were analyzed by Kaplan-Meier survival curve and Cox regression model.Results The age,FIGO stage,tumor differentiation,cervical invasion,tumor size,lymph node vessel invasion,parametrial extension and number of lymph node dissection were not significantly correlated with the rates of cumulative recurrence and survival after operation(P>0.05).The pathological type was correlated with the rate of cumulative recurrence(P<0.05),while the number and rate of lymph node metastasis were closely related to the rate of cumulative survival(P<0.05).The non-squamous cell cancer and lymph node metastasis>7.3% were the independent risk factors for influencing the recurrence of the patients with cervical cancer(HR=3.429 and 2.549,P<0.05),while the lymph node metastasis>7.3% was also an independent risk factor for influencing the survival after operation(HR=3.000,P<0.05).Conclusion The higher rate of lymph node metastasis is an independent risk factor for the poor prognosis of cervical cancer patients with lymph node metastasis.More attention should be paid to the patients with the rate of lymph node metastasis>7.3%.