宫颈癌患者发生盆腔淋巴结转移独立危险因素分析
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摘要
目的探讨宫颈癌患者发生盆腔淋巴结转移的独立危险因素,为宫颈癌患者的术前治疗方案以及预后分析提供一定的参考依据。方法选取宫颈癌患者共180例为研究对象,分为两组:未转移组(未发生盆腔淋巴结转移)154例和转移组(发生盆腔淋巴结转移) 26例。通过临床病理资料整理,采用多因素logistic回归分析,探讨宫颈癌患者发生盆腔淋巴结转移的独立危险因素。结果单因素分析结果显示:转移组年龄、临床分期、肿瘤直径大小、肿瘤浸润深度、脉管癌栓情况和肿瘤宫旁浸润情况与未转移组有显著不同,差异具有统计学意义(P <0.05),而分化程度、组织学类型、以及患者术前化疗情况尚未发现具有统计学差异(P> 0.05)。将单因素分析中有统计学意义的因素纳入到多因素分析。通过多因素logistic回归分析,结果显示:肿瘤直径大小、脉管癌栓情况、肿瘤浸润深度、以及肿瘤宫旁浸润情况是宫颈癌女性患者发生盆腔淋臣结转移的独立危险因素。结论宫颈癌女性患者易发生盆腔淋巴结转移的情况有:肿瘤直径≥4 cm、脉管癌栓阳性、肿瘤浸润深度≥2/3以及肿瘤宫旁浸润阳性。通过以上情况分析,对于宫颈癌患者的术前治疗方案以及预后分析有重要意义。
Objective To explore the independent risk factors of pelvic lymph node metastasis in patients with cervical cancer,and provide a reference for preoperative treatment and prognosis analysis of cervical cancer patients.Methods A total of180 patients with cervical cancer were enrolled and divided into two groups: 154 patients in the non-metastasis group( no pelvic lymph node metastasis) and 26 patients in the metastatic group( pelvic lymph node metastasis).Independent risk factors for pelvic lymph node metastasis in patients with cervical cancer were analyzed by clinical and pathological data and multivariate logistic regression analysis.Results Univariate analysis showed that the age,clinical stage,tumor diameter,tumor infiltration depth,vascular tumor thrombus and parametrial infiltration in the metastatic group were significantly different from those in the non-metastasis group,and the difference was statistically significant( P < 0.05).However,the degree of differentiation,histological type,and preoperative chemotherapy were not found to be statistically significant( P > 0.05).Statistically significant factors in the univariate analysis were included in the multivariate analysis.Multivariate logistic regression analysis showed that tumor size,vascular tumor thrombus,depth of tumor invasion,and parametrial infiltration were independent risk factors for pelvic lymph node metastasis in women with cervical cancer.Conclusion Female patients with cervical cancer are prone to pelvic lymph node metastasis: tumor diameter ≥4 cm,vascular tumor thrombus positive,tumor infiltration depth ≥2/3 and tumor parametrial infiltration positive.Through the above analysis,it is of great significance for the preoperative treatment plan and prognosis analysis of patients with cervical cancer.
Objective To explore the independent risk factors of pelvic lymph node metastasis in patients with cervical cancer,and provide a reference for preoperative treatment and prognosis analysis of cervical cancer patients.Methods A total of180 patients with cervical cancer were enrolled and divided into two groups: 154 patients in the non-metastasis group( no pelvic lymph node metastasis) and 26 patients in the metastatic group( pelvic lymph node metastasis).Independent risk factors for pelvic lymph node metastasis in patients with cervical cancer were analyzed by clinical and pathological data and multivariate logistic regression analysis.Results Univariate analysis showed that the age,clinical stage,tumor diameter,tumor infiltration depth,vascular tumor thrombus and parametrial infiltration in the metastatic group were significantly different from those in the non-metastasis group,and the difference was statistically significant( P < 0.05).However,the degree of differentiation,histological type,and preoperative chemotherapy were not found to be statistically significant( P > 0.05).Statistically significant factors in the univariate analysis were included in the multivariate analysis.Multivariate logistic regression analysis showed that tumor size,vascular tumor thrombus,depth of tumor invasion,and parametrial infiltration were independent risk factors for pelvic lymph node metastasis in women with cervical cancer.Conclusion Female patients with cervical cancer are prone to pelvic lymph node metastasis: tumor diameter ≥4 cm,vascular tumor thrombus positive,tumor infiltration depth ≥2/3 and tumor parametrial infiltration positive.Through the above analysis,it is of great significance for the preoperative treatment plan and prognosis analysis of patients with cervical cancer.
引文
[1]谢海霞,常淑芳,孙江川.前哨淋巴结活检对早期宫颈癌盆腔淋巴结转移诊断的Meta分析[J].实用妇产科杂志,2016,32(4):275-278.
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[9]赵红霞,董艳双,蔡友治,等.18F-氟脱氧葡萄糖的最大标准摄取值评估宫颈癌伴淋巴结转移患者预后的价值[J].中国全科医学,2017,20(6):668-672.
[10]崔瑜,樊琴娥,校林姣,等.纳米炭混悬注射液作为SLN示踪剂对早期宫颈癌盆腔淋巴结转移状态预测价值分析[J].中国性科学,2017,26(10):33-36.
[11]米桂兰,柳洲,舒志明,等.宫颈癌患者组织中C-met表达与宫颈癌患者淋巴结转移和复发的关系[J].中国性科学,2017,26(5):52-55.
[12]于洪波,杨雷,于海莲,等.宫颈癌淋巴结转移高危因素的临床分析[J].实用癌症杂志,2017,32(4):678-680.
[13]祝莉,曲丽霞,权丽丽.宫颈癌盆腔淋巴结转移的临床特征及影响因素分析[J].癌症进展,2017,15(9):1079-1081.
[14]Wu Q,Zheng D,Shi L,et al.Differentiating metastatic from nonmetastatic lymph nodes in cervical cancer patients using monoexponential,biexponential,and stretched exponential diffusion-weighted MR imaging[J].Euro Rad,2017,27(12):1-8.
[15]柏家英,何丽萍,杨英捷,等.p16、HPV、CK20在宫颈癌淋巴结微转移中的表达及意义[J].贵州医药,2017,41(11):1129-1131.
[16]秦莹,刘梅,漆海宁,等.宫颈癌组织中c-met的表达与宫颈癌患者淋巴结转移及复发的关系[J].现代生物医学进展,2016,16(31):6138-6140.
[17]马莉,杨燕.影像学检测肿瘤直径和淋巴结转移在宫颈癌患者预后中的价值研究[J].中国现代医学杂志,2016,26(18):94-99.
[18]Jouglar E,Thomas L,De lRA,et al.Toxicity and early clinical outcomes in cervical cancer following extended field helical tomotherapy to para-aortic lymph nodes[J].Cancer,2016,20(8):794.
[2]汪侠,李振华,解宝江.彩色多普勒超声对宫颈癌盆腔淋巴结转移的诊断价值[J].实用癌症杂志,2016,31(6):1009-1011.
[3]余莹莹,赵艳萍,周永,等.CT诊断早期宫颈癌淋巴结转移的价值[J].中国临床医学影像杂志,2016,27(8):565-569.
[4]Cibula D,Zikan M,Slama J,et al.Risk of micrometastases in non-sentinel pelvic lymph nodes in cervical cancer[J].Gynecol Oncol,2016,143(1):83-86.
[5]董延江,桑颖.LAVA序列增强扫描显示在宫颈癌淋巴结转移判定中的应用[J].中国CT和MRI杂志,2016,14(1):106-108.
[6]Han X,Wen H,Ju X,et al.Predictive factors of para-aortic lymph nodes metastasis in cervical cancer patients:a retrospective analysis based on 723 para-aortic lymphadenectomy cases[J].Oncotarget,2017,8(31):51840.
[7]陈真云,李秀敏,盛修贵,等.宫颈癌盆腔淋巴结转移同步推量调强放射治疗的临床研究[J].中华肿瘤防治杂志,2016,23(23):1565-1571.
[8]陈琪,张虹.早期宫颈癌淋巴结转移高危因素的探讨[J].国际妇产科学杂志,2016,43(2):181-183.
[9]赵红霞,董艳双,蔡友治,等.18F-氟脱氧葡萄糖的最大标准摄取值评估宫颈癌伴淋巴结转移患者预后的价值[J].中国全科医学,2017,20(6):668-672.
[10]崔瑜,樊琴娥,校林姣,等.纳米炭混悬注射液作为SLN示踪剂对早期宫颈癌盆腔淋巴结转移状态预测价值分析[J].中国性科学,2017,26(10):33-36.
[11]米桂兰,柳洲,舒志明,等.宫颈癌患者组织中C-met表达与宫颈癌患者淋巴结转移和复发的关系[J].中国性科学,2017,26(5):52-55.
[12]于洪波,杨雷,于海莲,等.宫颈癌淋巴结转移高危因素的临床分析[J].实用癌症杂志,2017,32(4):678-680.
[13]祝莉,曲丽霞,权丽丽.宫颈癌盆腔淋巴结转移的临床特征及影响因素分析[J].癌症进展,2017,15(9):1079-1081.
[14]Wu Q,Zheng D,Shi L,et al.Differentiating metastatic from nonmetastatic lymph nodes in cervical cancer patients using monoexponential,biexponential,and stretched exponential diffusion-weighted MR imaging[J].Euro Rad,2017,27(12):1-8.
[15]柏家英,何丽萍,杨英捷,等.p16、HPV、CK20在宫颈癌淋巴结微转移中的表达及意义[J].贵州医药,2017,41(11):1129-1131.
[16]秦莹,刘梅,漆海宁,等.宫颈癌组织中c-met的表达与宫颈癌患者淋巴结转移及复发的关系[J].现代生物医学进展,2016,16(31):6138-6140.
[17]马莉,杨燕.影像学检测肿瘤直径和淋巴结转移在宫颈癌患者预后中的价值研究[J].中国现代医学杂志,2016,26(18):94-99.
[18]Jouglar E,Thomas L,De lRA,et al.Toxicity and early clinical outcomes in cervical cancer following extended field helical tomotherapy to para-aortic lymph nodes[J].Cancer,2016,20(8):794.