探讨宫颈鳞癌ⅠB1期盆腔淋巴结转移及复发的影响因素

Exploring the Influencing Factors Associated With Pelvic Lymph Node Metastasis and Recurrence in Patients With StageⅠB1 Cervical Squamous Cell Carcinoma

目的探讨宫颈鳞状细胞癌ⅠB1期患者盆腔淋巴结转移及复发的相关影响因素。方法收集2005年4月—2018年7月接受早期宫颈癌根治手术的ⅠB1期宫颈鳞癌患者的数据。主要从病理分化程度、脉管浸润与否、宫体侵犯与否、病灶浸润深度、手术路径方面探讨其与宫颈鳞癌患者ⅠB1期盆腔淋巴结转移的相关性;从病理分化程度、淋巴结转移与否、脉管浸润与否、宫体侵犯与否、病灶浸润深度、手术路径方面探讨了其与宫颈癌患者复发的相关性。结果在单因素分析中,盆腔淋巴结转移组的脉管浸润率高于无盆腔淋巴结转移组的脉管浸润率(51.85%vs.15.40%,P<0.001)。盆腔淋巴结转移组患者的病灶浸润深度≥5 mm发生率高于无盆腔淋巴结转移组(81.48%vs.68.41%,P=0.029)。盆腔淋巴结转移组的宫体侵犯率高于无盆腔淋巴结转移组(25.93%vs.8.88%,P=0.012)。在Logistic回归分析中,淋巴结转移组与无淋巴结转移组间的脉管浸润差异有统计学意义(P=0.016)。在单因素分析中,复发组的病灶浸润深度≥5 mm发生率高于无复发组(85.37%vs.68.56%,P=0.026)。复发组的宫体侵犯率高于无复发组(19.51%vs.8.94%,P=0.049)。复发组的淋巴结转移率高于无复发组(17.07%vs.5.42%,P=0.012)。在Logistic回归分析中,复发组与无复发组间的盆腔淋巴结转移比较,差异有统计学意义(P=0.016)。结论宫颈鳞状细胞癌ⅠB1期患者淋巴结转移与脉管浸润、宫体侵犯、病灶浸润深度有关,其中脉管浸润是盆腔淋巴结转移的独立危险因素。宫颈鳞状细胞癌ⅠB1期患者复发与盆腔淋巴结转移、宫体侵犯、病灶浸润深度有关,其中盆腔淋巴结转移是复发的独立危险因素。

Objective To explore the influencing factors related to pelvic lymph node metastasis and recurrence in patients with stageⅠB1 cervical squamous cell carcinoma.Methods Data were collected from patients with stageⅠB1 squamous cervical cancer who underwent radical surgery for early-stage cervical cancer from April 2005 to July 2018.The correlation with pelvic lymph node metastasis in stageⅠB1 cervical squamous cancer patients was explored mainly in terms of degree of pathological differentiation,choroidal infiltration or not,uterine body invasion or not,depth of lesion infiltration,and surgical route;the correlation with recurrence in cervical cancer patients was explored in terms of degree of pathological differentiation,lymph node metastasis or not,choroidal infiltration or not,uterine body invasion or not,depth of lesion infiltration,and surgical route.Results In the univariate analysis,the rate of pulsatile infiltration was higher in the group with pelvic lymph node metastasis than the group without pelvic lymph node metastasis(51.85%vs.15.40%,P<0.001).The incidence of lesion infiltration≥5 mm was higher in the pelvic lymph node metastasis group than in the no pelvic lymph node metastasis group(81.48%vs.68.41%,P=0.029).The rate of uterine body invasion was higher in the group with pelvic lymph node metastases than the group without pelvic lymph node metastases(25.93%vs.8.88%,P=0.012).In a Logistic regression analysis,vascular infiltration was statistically significant between the lymph node metastasis group and the no lymph node metastasis group(P=0.016).In univariate analysis,the incidence of lesion infiltration≥5 mm in depth was higher in the recurrence group than the no recurrence group(85.37%vs.68.56%,P=0.026).The rate of uterine body invasion was higher in the recurrence group than the no recurrence group(19.51%vs.8.94%,P=0.049).The rate of lymph node metastasis was higher in the recurrence group than in the no recurrence group(17.07%vs.5.42%,P=0.012).In a Logistic regression analysis,pelvic lymph node metastasis was statistically significant between the recurrence group and the no recurrence group(P=0.016).Conclusion Lymph node metastasis in patients with stageⅠB1 cervical squamous cell carcinoma was associated with choroidal infiltration,uterine body invasion,and depth of lesion infiltration,with choroidal infiltration being an independent risk factor for pelvic lymph node metastasis.Recurrence of stageⅠB1 cervical squamous cell carcinoma was associated with pelvic lymph node metastasis,uterine body invasion,and depth of lesion infiltration,with pelvic lymph node metastasis being an independent risk factor for recurrence.