早期宫颈癌宫旁转移的危险因素分析

Analysis of Risk Factors for Early Cervical Cancer with Paruterine Metastasis

目的:分析早期宫颈癌(ⅠA2和ⅠB1期)患者发生宫旁转移的危险因素。方法:选取2005年1月—2019年12月广东省妇幼保健院收治的630例ⅠA2~ⅠB1期宫颈癌患者为研究对象。根据病理诊断结果,将患者分为宫旁转移组和未宫旁转移组。比较两组临床资料(年龄、分期、肿瘤直径、病理类型、组织学分级、脉管浸润情况、淋巴转移情况、间质浸润情况、累及阴道情况)。采用Logistic回归分析早期宫颈癌宫旁转移的独立危险因素。结果:本研究630例患者中,发生宫旁转移48例,占比7.62%。两组年龄、分期、病理类型、组织学分级比较,无统计学差异(P>0.05);宫旁转移组肿瘤直径大于未宫旁转移组,脉管浸润、淋巴转移、累及阴道占比大于未宫旁转移组,间质浸润深于未宫旁转移组(P<0.05)。Logistic分析结果显示,肿瘤直径>2 cm、脉管浸润、淋巴转移是早期宫颈癌患者宫旁转移的独立危险因素(P<0.05)。结论:早期宫颈癌患者肿瘤直径>2 cm或发生脉管浸润、淋巴转移,则其发生宫旁转移的风险较高,有必要开展根治性子宫切除术。

Objective:To analyze the risk factors of parastatal metastasis in patients with early cervical cancer(stageⅠA2 andⅠB1).Methods:A total of six hundred and thirty patients with stageⅠA2~ⅠB1 cervical cancer treated in Guangdong Maternal and Child Health Hospital from January 2005 to December 2019 were selected as the study objects.According to the pathological diagnosis,the patients were divided into two groups:paraventral metastasis group and non-paraventral metastasis group.Clinical data(age,stage,tumor diameter,pathological type,histological grade,vascular invasion,lymphatic metastasis,interstitial invasion,and vaginal involvement)were compared between the two groups.Logistic regression was used to analyze the independent risk factors of early cervical cancer with parastatal metastasis.Results:In this study,among 630 patients,48 cases(7.62%)had paracentral metastasis.There were no significant differences in age,stage,pathological type and histological grade between the two groups(P>0.05);the tumor diameter in the paraventral metastasis group was greater than that in the nonparaventral metastasis group,the proportion of vascular invasion,lymphatic metastasis and vaginal involvement was greater than that in the non-paraventral metastasis group,and the depth of interstitial invasion was greater than that in the non-paraventral metastasis group(P<0.05).Logistic analysis showed that tumor diameter>2 cm,vascular invasion and lymphatic metastasis were independent risk factors for parafunctal metastasis in early cervical cancer patients(P<0.05).Conclusion:Early cervical cancer patients with tumor diameter>2 cm or vascular invasion,lymphatic metastasis,the risk of parafunctal metastasis is higher,it is necessary to carry out radical hysterectomy.