摘要
【目的】探讨早期巨块型宫颈癌患者淋巴结转移分布的规律及其与预后的关系。【方法】回顾性分析2011年1月至2015年3月在汕头大学医学院附属肿瘤医院收治的157例局部晚期宫颈癌患者(局部肿瘤>4 cm的Ib2或Ⅱa2期),收集其临床病理资料,并随访患者生存情况。【结果】157例患者中50例(31.8%)发生淋巴结转移(LNM),以闭孔/宫旁淋巴结转移最常见;10例(6.4%)发生髂总淋巴结转移;腹主动脉旁淋巴结阳性的患者均伴有盆腔淋巴结转移。病理类型、深肌层浸润、淋巴脉管间隙浸润、宫旁受累均为淋巴结转移的独立危险因素(P<0.05),淋巴结转移以及病理分级是影响宫颈癌预后的独立因素(P<0.05),高位淋巴结转移或者淋巴结转移数目>2枚,预后更差(P<0.05)。【结论】早期巨块型宫颈癌以闭孔/宫旁淋巴结最易转移,淋巴结基本遵循逐级转移的规律;淋巴结转移部位越高或者数目越多,预后越差。
[ Objective ] To explore lymph node metastasis pattern of early-stage bulky cervical carcinoma and its relationship with patients＇ prognosis. [Methods]The clinical, pathologic and follow-up data of 157 cases with early-stage bulky cervical carcinoma treated in Affiliated Tumor Hospital of Shantou University Medical College from Jun. 2011 to Mar. 2015 were analyzed retrospectively. [Results] 50 patients had lymph node metastasis （31.8%）. 10 patients （6.4%） had common iliac lymph node metastasis. Obturator / parametrial lymph nodes were most vulnerable to lymphatic metastasis anatomically. All the patients with para-aortic lymph node metastasis had pelvic lymph node metastasis as well. Pathological type, deep myometrial infiltration, lymph vascular space invasion and parametrial involvement were the independent risk factors for lymph node metastasis （P 〈 0.05）. Two independent factors as lymph node metastasis and histological grade were related to prognosis of cervical carcinoma （P 〈 0.05）. more than two lymph node metastases or higher site of lymph node metastasis meant worse survival status（P 〈 0.05 ）. [Conclusion] Obturator / parametrial lymph nodes were most vulnerable. The mode of lymph node metastasis in early-stage bulky cervical carcinoma was step by step. The higher site of lymph node metastasis or more lymph node metastases, the worse prognosis the patients had.
作者
关明飞
黄萍
朱安娜
李从铸
周莉
李燕
GUAN Ming-fei HUANG Ping ZHU An-na LI Cong-zhu ZHOU Li LI Yan(Department of Gynecology, Affiliated Tumor Hospital of Shantou University Medical College, Shantou 515031, China)
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2016年第5期728-732,共5页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省医学科学技术研究基金(20151222239423)
关键词
宫颈癌
淋巴结转移
腹膜后淋巴结切除
预后
cervical carcinoma
lymph node metastasis
retroperitoneal lymphadenectomy
prognosis
