IA2-IB1期宫颈癌宫旁转移相关因素分析

Analysis of clinical factors correlated with parametrial metastasis in stage IA2-IB1 cervical cancer

关键词:  早期宫颈癌  宫旁转移  危险因素

Key words:  cervical cancer at early stage  parametrial metastasi  risk factors

摘要:

目的 探讨IA2-IB1期宫颈癌患者宫旁转移的相关因素。方法 回顾性分析168例行手术治疗的IA2-IB1期宫颈癌患者的临床资料，包括年龄、分期、肿瘤直径、血清鳞状细胞癌抗原（squamous cell carcinoma antigen，SCC）数值，肿瘤组织学类型、肿瘤浸润深度、肿瘤细胞分化程度、盆腔淋巴结转移情况、脉管浸润情况、宫旁转移情况等，对宫旁转移的相关因素进行单因素和多因素分析。结果 168例IA2-IB1期宫颈癌患者中9例发生宫旁转移，宫旁转移率为5.4%。单因素分析显示肿瘤直径>2 cm、血清SCC值显著升高、肿瘤肌层浸润深度>1/2肌层、脉管浸润阳性、盆腔淋巴结转移阳性与宫旁转移密切相关（P<0.05），而年龄、临床分期、肿瘤细胞分化程度、肿瘤组织类型与宫旁转移无关。多因素分析显示肿瘤直径>2 cm、脉管浸润、盆腔淋巴结转移是IA2-IB1期宫颈癌宫旁转移的独立危险因素。结论 IA2-IB1期宫颈癌患者宫旁转移率低，肿瘤直径>2 cm、脉管浸润、盆腔淋巴结转移的患者易发生宫旁转移。

Abstract:

Objective To study the risk factors correlated with parametrial metastasis in patients with stage IA2-IB1 cervical cancer. Methods The clinical pathological characters of 168 surgical cases of stage IA2-IB1 cervical cancer were collected, including age, stage, tumor diameter, serum SCC level, histological classification, depth of invasion, degree of differentiation, pelvic lymph node metastasis, lymph vascular invasion, parametrial metastasis and other clinical information. Univariate and multivariate analysis were performed on the risk factors correlated with parametrial metastasis. Results Parametrial metastasis occurred in 9 cases among 168 cases of stage IA2-IB1 cervical cancer (5.4%). Univariate analysis revealed that tumor diameter>2 cm, high SCC level in serum, depth of invasion >1/2 muscular layer, positive lymph vascular invasion, and pelvic lymph node metastasis were correlated with parametrial metastasis (P<0.05), while age, pathological stage, degree of differentiation and histological classification had no correlation with parametrial metastasis. Multivariate analysis demonstrated that tumor diameter>2 cm, positive lymph vascular invasion, and pelvic lymph node metastasis were independent risk factors of parametrial metastasis. Conclusion The risk of parametrial metastasis is low in stage IA2-IB1 cervical cancer. The independent risk factors of parametrial metastasis include tumor diameter>2 cm, lymph vascular invasion, and pelvic lymph node metastasis.