摘要
目的：探讨早期宫颈鳞状细胞癌患者盆腔淋巴结转移的危险因素。方法：回顾分析152例行手术治疗的 IB - IIA 期宫颈鳞癌患者的临床资料，分析患者的年龄、临床分期、肿瘤细胞分化程度、宫颈间质浸润深度、肿瘤直径大小、脉管癌栓、术前血清宫颈鳞状上皮抗原（SCC-Ag）水平、治疗前血浆纤维蛋白原（FIB）水平及 D-二聚体水平9个指标与盆腔淋巴结转移的关系。结果：152例 IB- IIA 期宫颈鳞癌患者中20例存在盆腔淋巴结转移（13.16%）。单因素分析结果显示，宫颈间质浸润深度、肿瘤直径、脉管癌栓、术前血清 SCC-Ag 水平及血浆 FIB 水平与盆腔淋巴结转移有关，差异有统计学意义（ P 〈0.05）；淋巴结阳性患者的血浆 D-二聚体水平高于阴性患者，但差异无统计学意义（P〉0.05）。多因素分析结果显示，脉管癌栓、术前血清 SCC-Ag 及血浆 FIB 水平与盆腔淋巴结转移相关，差异有统计学意义（P〈0.05）。结论：脉管癌栓、术前血清 SCC-Ag 水平及治疗前血浆 FIB 水平是 IB-IIA 期宫颈鳞癌患者盆腔淋巴结转移的独立危险因素，而术前D-二聚体水平与盆腔淋巴结转移之间的关系，尚需进一步研究。
Objective：To evaluate the risk factors for the presence of pelvic lymph node metastasis in early-stage cervical squamous cell carcinoma. Methods：One hundred and fifty-two patients with stage IB - IIA cervical squamous cell carcinoma who were undertaken rad-ical hysterectomy and pelvic lymph node dissection were retrospectively collected. To analyze the relation of pelvic lymph node metastasis with age,clinical stage,grade of differentiation, depth of interstitial invasion,tumor size,lymphatic vascular space invasion,pretreatment level of serum squamous cell carcinoma antigen （ SCC-Ag）, pretreatment plasma level of fibrinogen （FIB）,pretreatment level of D-dimer. Results：Twenty patients of the 152 early-stage cervical squamous cell carcinoma had pelvic lymph node metastasis[13. 16% （20 / 152）]. Univariate a-nalysis showed that depth of interstitial invasion,tumor size,lymphatic vascular space invasion, pretreatment level of serum SCC-Ag and pretreatment plasma level of FIB was significantly re-lated to pelvic lymph node metastasis （P〈0. 05）. The level of D-dimer was higher in patients with lymph node metastasis when compared to patients who didn＇t,but the difference wasn＇t sta-tistically significant（P〉0. 05）. Multivariate analysis showed those lymphatic vascular space in-vasion,pretreatment level of serum SCC-Ag and pretreatment plasma level of FIB were inde-pendently correlated with lymph node metastasis in early-stage cervical squamous cell carcinoma （P〈0. 05）. Conclusions：In early-stage cervical squamous cell carcinoma,lymphatic vascular space invasion,pretreatment level of serum SCC-Ag and pretreatment plasma level of FIB was independently related to lymph node metastasis,while pretreatment level of D-dimer showed no significant connection with lymph node metastasis.
出处
《现代妇产科进展》
CSCD
2014年第11期860-863,共4页
Progress in Obstetrics and Gynecology
关键词
宫颈癌
淋巴结转移
高危因素
D-二聚体
Cervical carcinoma
Lymph node metastasis
High-risk factors
D-dimer
