Ⅰ、Ⅱa期宫颈癌盆腔淋巴结转移危险因素探究.docVIP

Ⅰ、Ⅱa期宫颈癌盆腔淋巴结转移危险因素探究【摘要】 目的 探讨Ⅰ、Ⅱa期宫颈癌盆腔淋巴结转移的高危因素。方法 对根治术后208例Ⅰ、Ⅱa期宫颈癌患者临床与病理资料进行回顾性分析。结果 临床分期、病理分级、浸润深度、肿瘤大小及形态、年龄与淋巴结转移显著相关。病理类型及宫体转移与淋巴结转移无相关性。结论 临床分期晚，病理分级差，肌层浸润≥1/2，肿瘤直径≥4 cm，内生型肿瘤，年龄≤35岁均为Ⅰ、Ⅱa期宫颈癌淋巴结转移高危因素。 【关键词】 子宫颈癌；淋巴结转移；高危因素 A preliminary study on the risk metastatic factors of pelvic lymph nodes in patients with cervical carcinoma of stage I and IIa. ZHAO Ying, DU Pei-yan, HUANG Shou-song.Guangzhou City Tumor Hospital, Guangzhou 510000,China 【Abstract】 Objective To investigate the metastatic risk factors of pelvic lymph nodes in patients with cervical carcinoma of stage I and IIa.Methods The clinical and pathological information of 208 patients with cervical carcinoma of stage I and IIa after radical hysterectomy with pelvic lymphadenectomy were retrospectively analysed.Results Clinical stage, pathological grade, myometrial invation, tumor size, growth type and age were closely related to the metastasis of lymph nodes. No significant difference was found between squamous cell carcinoma and adenocarcinoma, uteroabdominal metastasis cases and no metastasis uterroabdominal cases.Conclusion The lated stage, worse in pathological grade, myometrial invation ≥1/2, tumor diameter ≥4 cm, endophytic type and age ≤35 are all the risk factors of lymph node， metastasis in cervical carcinoma of stage I and IIa. 【Key words】 Cervical cancer;Lymph nodes metastasis; Risk factors 盆腔淋巴结转移是宫颈癌扩散的重要途径，有无淋巴结转移，直接影响患者的预后。本研究对经手术病理证实的208例Ⅰ、Ⅱa期宫颈癌患者淋巴结转移情况加以分析，旨在探讨Ⅰ、Ⅱa期宫颈癌盆腔淋巴结转移的相关危险因素。 1 资料与方法 1.1 一般资料 我院1990年1月至2005年6月共行宫颈癌根治术208例。年龄22～68岁，中位年龄46岁。按1988年ＦＩＧＯ分期标准：Ⅰa期31例，Ⅰb期56例，Ⅱa期121例。其中鳞癌182例，腺癌13例，腺鳞癌12例，小细胞癌1例。肿瘤形态及大小按治疗前临床检查记录分为结节型者53例，菜花型者126例，溃疡型者29例；肿瘤直径≥4 cm的86例，＜4 cm的122例。 1.2 治疗方法 208例宫颈癌患者施以广泛性子宫切除并盆腔淋巴结清扫术，对Ⅰｂ～Ⅱａ期肿瘤直径≥4 cm者86例，术前行单纯腔内治疗者27例,Ａ点剂量15～20 Ｇy，腔内治疗同时行介入治疗者59例，放疗或化疗后休息10～14 d行手术治疗。 1.3 统计学方法 淋巴结转移率所占构成比差异用χ2检验。 2 结果 208例患者中有盆腔淋巴结转移者58例，转移率为27.8%。影响盆腔淋巴结转移的相关因素见表1。 结果表明，临床分期、病理分级、浸润深度、肿瘤大小及形态、年龄与盆腔淋巴结转移关系密切，各组比较差异有统计学意