宫颈癌临床病理特征与盆腔淋巴结转移的相关性分析
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摘要
目的分析宫颈癌临床病理特征与盆腔淋巴结转移之间的关系。方法回顾性分析温州市中西医结合医院2015年3月—2017年3月收治的宫颈癌患者102例,其中有盆腔淋巴结转移者共22例(21.57%),作为观察组,其余80例无盆腔淋巴结转移者为对照组,观察并探讨2组患者肿瘤分期、组织学类型、生长类型等与盆腔淋巴结转移之间的关系。结果观察组患者中有绝经期9例,占40.91%(9/22),对照组22例,占27.50%(22/80),2组差异有统计学意义(P<0.05)。观察组高危型HPV阳性22例,占100%;Ⅰb 14例,占63.64%(14/22),Ⅱa 8例,占36.36%(8/22);14例肿瘤直径≥4 cm,占63.64%(14/22)。观察组10例宫颈肌层癌浸润深度>2/3(45.45%),对照组17例(21.25%),2组差异有统计学意义(P<0.05);观察组内生型17例,外生型5例,没有溃疡型及颈管型,与对照组比较差异有统计学意义(P<0.05)。盆腔淋巴结转移与年龄、组织学分型等无明显相关。结论宫颈癌患者有高危型HPV、临床分期、肿瘤大小与盆腔淋巴结转移有关,且宫颈肌层癌浸润深度>2/3、内生型的宫颈癌患者,其盆腔淋巴结转移率较高。
Objective To analyze the relationship between the clinicopathological features of the cervical cancer patients and pelvic lymph node metastasis. Methods We chose 102 cervical cancer patients who were admitted to our hospital from March 2015 to March 2017, including 22 cases with pelvic lymph node metastasis, the metastasis rate was 21.57%, as the observation group, the other 80 cases without pelvic lymph node metastasis as the control group, observed and discussed the two groups of tumor staging, histology type, growth type, and so on. We compared the relationship between the tumor staging, histology type, growth type with pelvic lymph node metastasis. Results In the observation group, there were 9 cases of menopause, 9/22(40.91%) and 22 cases in the control group, accounting for 22/80(27.5%), the difference was statistically significant(P<0.05); high risk HPV positive 22 cases, 100%, negative 0 cases; IB 14 cases,14/22(63.64%), IIa have 8 cases, accounting for 8/22(36.36%); there were 14 cases of tumor more than 4 cm, accounting for 14/22(63.64%), 8 cases of tumor<4 cm, accounting for 8/22(36.36%), the difference was statistically significant(P<0.05); 10 cases(45.45%) of the invasive depth of cervical myometrium in the observation group, 17(21.25%) in the control group(21.25%), and statistically significant(P<0.05) in the observation group(P<0.05). There were 17 cases of edophytic type, 5 cases of exophytic type, 0 cases of ulcerative type and cervical type in the observation group, compared with the control group, the difference was statistically significant(P<0.05). Conclusion The patients with cervical cancer have high risk of HPV, the clinical staging and the tumor size are related to the pelvic lymph node metastasis. The adenocarcinoma and endogenetic cervical cancer patients have higher pelvic lymph node metastasis, which provides a reference for the individualized treatment of cervical cancer patients.
Objective To analyze the relationship between the clinicopathological features of the cervical cancer patients and pelvic lymph node metastasis. Methods We chose 102 cervical cancer patients who were admitted to our hospital from March 2015 to March 2017, including 22 cases with pelvic lymph node metastasis, the metastasis rate was 21.57%, as the observation group, the other 80 cases without pelvic lymph node metastasis as the control group, observed and discussed the two groups of tumor staging, histology type, growth type, and so on. We compared the relationship between the tumor staging, histology type, growth type with pelvic lymph node metastasis. Results In the observation group, there were 9 cases of menopause, 9/22(40.91%) and 22 cases in the control group, accounting for 22/80(27.5%), the difference was statistically significant(P<0.05); high risk HPV positive 22 cases, 100%, negative 0 cases; IB 14 cases,14/22(63.64%), IIa have 8 cases, accounting for 8/22(36.36%); there were 14 cases of tumor more than 4 cm, accounting for 14/22(63.64%), 8 cases of tumor<4 cm, accounting for 8/22(36.36%), the difference was statistically significant(P<0.05); 10 cases(45.45%) of the invasive depth of cervical myometrium in the observation group, 17(21.25%) in the control group(21.25%), and statistically significant(P<0.05) in the observation group(P<0.05). There were 17 cases of edophytic type, 5 cases of exophytic type, 0 cases of ulcerative type and cervical type in the observation group, compared with the control group, the difference was statistically significant(P<0.05). Conclusion The patients with cervical cancer have high risk of HPV, the clinical staging and the tumor size are related to the pelvic lymph node metastasis. The adenocarcinoma and endogenetic cervical cancer patients have higher pelvic lymph node metastasis, which provides a reference for the individualized treatment of cervical cancer patients.
引文
[1] 宋亮,谢思遐,战军,等.652例早期宫颈癌患者临床病理特征分析及选择低危患者条件探讨[J].实用妇产科杂志,2016,32(2):126-129.
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[10] 王金华,郑秀,陈丽红,等.血清鳞癌相关抗原、糖类抗原125表达与宫颈癌临床分期的相关性[J].中国临床药理学杂志,2015,31(15):1546-1548.
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[12] NIU C,SUN X,ZHANG W,et al.NR2F6 Expression Correlates with Pelvic Lymph Node Metastasis and Poor Prognosis in Early-Stage Cervical Cancer[J].Int J Mol Sci,2016,17(10):E1694.
[13] 蔡斌,吴昊,丰有吉,等.100例宫颈癌临床病理特征与宫旁侵犯和盆腔淋巴结转移的关系分析[J].实用妇产科杂志,2015,31(5):366-368.
[14] ZHANG W,OU J,LEI F,et al.C14ORF166 overexpression is associated with pelvic lymph node metastasis and poor prognosis in uterine cervical cancer[J].Tumour Biol,2016,37(1):369-379.
[15] 李素玉,郑祥钦,宋建榕,等.Ⅰb～Ⅱb期宫颈癌盆腔淋巴结转移相关因素分析与预测[J].现代妇产科进展,2018,27(4):263-267.
[16] 刘山,张映红,魏巍,等.Ⅰ～Ⅱa期宫颈癌淋巴结转移的相关因素分析[J].中华全科医学,2015,13(9):1468-1469,1476.
[2] 余少敏,成敏,侯靓思,等.热休克因子1表达与宫颈癌临床病理特征及生存的关系[J].第三军医大学学报,2017,39(6):560-563.
[3] 柴红娟,施薇,杜光烨,等.D2-40在宫颈癌淋巴管生成、淋巴管浸润中的临床意义[J].实用医学杂志,2014,30(12):2019-2020.
[4] 赵琳琳,徐文杰,孙聚葆.Ⅰb1～Ⅱa2期宫颈癌的DWI相关参数与其盆腔淋巴结转移的相关性[J].实用医学杂志,2018,34(3):431-434.
[5] 刘昱,赵丽君,李明珠,等.ⅠA～ⅡB期子宫颈鳞癌盆腔淋巴结转移的临床病理高危因素[J].中国妇产科临床杂志,2016,17(2):122-124.
[6] 于岩岩,董越,董瑞彤,等.ⅠB1～ⅡA1期宫颈鳞癌盆腔淋巴结转移的相关因素分析及3.0T MR-DWI的预测价值[J].放射学实践,2017,32(4):325-327.
[7] 尹月菊,盛修贵,李兴兰,等.早期宫颈癌髂外末端淋巴结转移规律和影响因素[J].中华肿瘤杂志,2014,36(6):457-460.
[8] 李可心,孙洪赞,辛军,等.早期宫颈癌盆腔淋巴结转移危险因素及PET/CT诊断[J].中国医学影像技术,2018,34(2):265-269.
[9] 张庆华,徐文生,蓝喜.Ⅰ型子宫内膜癌患者盆腔淋巴结转移危险因素分析[J].实用妇产科杂志,2017,33(8):603-605.
[10] 王金华,郑秀,陈丽红,等.血清鳞癌相关抗原、糖类抗原125表达与宫颈癌临床分期的相关性[J].中国临床药理学杂志,2015,31(15):1546-1548.
[11] 赵珊,姚德生,陈军莹,等.血清miR-203与宫颈癌临床病理特征的关系[J].重庆医学,2014,43(8):972-975.
[12] NIU C,SUN X,ZHANG W,et al.NR2F6 Expression Correlates with Pelvic Lymph Node Metastasis and Poor Prognosis in Early-Stage Cervical Cancer[J].Int J Mol Sci,2016,17(10):E1694.
[13] 蔡斌,吴昊,丰有吉,等.100例宫颈癌临床病理特征与宫旁侵犯和盆腔淋巴结转移的关系分析[J].实用妇产科杂志,2015,31(5):366-368.
[14] ZHANG W,OU J,LEI F,et al.C14ORF166 overexpression is associated with pelvic lymph node metastasis and poor prognosis in uterine cervical cancer[J].Tumour Biol,2016,37(1):369-379.
[15] 李素玉,郑祥钦,宋建榕,等.Ⅰb～Ⅱb期宫颈癌盆腔淋巴结转移相关因素分析与预测[J].现代妇产科进展,2018,27(4):263-267.
[16] 刘山,张映红,魏巍,等.Ⅰ～Ⅱa期宫颈癌淋巴结转移的相关因素分析[J].中华全科医学,2015,13(9):1468-1469,1476.