摘要
目的分析宫颈癌患者淋巴结转移的特征及其对预后的影响。方法前瞻性研究手术治疗的宫颈癌患者311例,记录术中切除的淋巴结数量、部位、体积和病理结果,随访5年生存状况。结果 (1)311例患者淋巴结转移率23.8%,闭孔处转移率最高62.2%,主要沿宫旁淋巴结→闭孔→髂内、髂外→髂总→直肠旁→腹主动脉淋巴结引流途径顺次转移,3例为跳跃式转移。(2)在影响预后的多因素分析中,淋巴结转移(RR=3.524,95%CI:2.156-5.763)首先入选Cox回归模型。有、无淋巴结转移者的5年生存率分别为54.5%和86.1%(χ2=33.681,P<0.01)。(3)淋巴结转移个数和转移处数的风险比分别是2.441(95%CI:1.464-4.069)和2.484(95%CI:1.119-5.517),淋巴结转移数目≤3枚、4～10枚和>10枚者5年生存率分别是80.0%、57.6%和22.5%(χ2=14.340,P<0.01)。单处淋巴结转移和多处淋巴结转移者的5年生存率分别是72.0%和43.1%(χ2=5.887,P<0.05)。结论宫颈癌淋巴结转移主要沿淋巴引流途径进行,以闭孔处转移最常见。淋巴结转移状态是影响患者预后的最强因素,转移个数和转移处数越多,预后越差。
Objective To analyze the features of lymph node metastasis and their influences on prognosis of patients with cervical cancer. Methods A retrospective analysis was made in 311 patients with cervical cancer treated by surgery. Number, location, size and pathological findings of removed lymph nodes were recorded, and 5-year survival situations of all patients were followed-up. Results （ 1 ） The lymph node metastasis rate of all studied patients was 23.8% （74/311 ）, and it was up to 62.2% （46/74） at obturator. The lymph node metastasis pathway mainly passed along the parametrial lymph nodes to obturator, iliac or external iliac, common iliac lymph nodes, perirectal lymph node, and then to the abdominal aor- tic lymph node. Three cases was skip metastasis. （2） In the multivariate analysis of prognostic factors, 5-year survival rates in patients with or without lymph node metastasis were 54.5% and 86.1% respectively （P 〈0.01 ）. （3） The risk ratios of the number and stations of lymph node metastasis were 2. 441 （95% CI ： 1. 464 - 4 . 069） and 2. 484 （95% CI： 1.119 - 5. 517） respectively; 5-year survival rates in patients with metastatic lymph node number≤〈3, 4-10, 〉 10 were 80.0%, 57.6% and 22.5% respectively （P 〈 0.01 ） ; 5-year survival rates of patients with single station lymph node metastasis and multiple lymph node metastasis were 72.0% and 43.1% respectively （P 〈 0.05）. Conclusions Lymph node metastasis of cervical cancer always passes along the lymphatic drainage pathways, and obturator lymph node metastasis is most common found. Lymph node status is an important affecting factor of the prognosis. The more of the lymph nodes metastasis number, the worse prognosis of the patients.
出处
《中国临床研究》
CAS
2012年第7期637-639,共3页
Chinese Journal of Clinical Research
关键词
宫颈肿瘤
淋巴结转移
预后
Cervical cancer
Lymph node metastasis
Prognosis
