论文部分内容阅读
目的探讨ⅠB～ⅡB期宫颈鳞癌手术治疗后出现颈部淋巴结转移的相关危险因素、分布规律及预后的影响因素。方法回顾性分析2003-2010年新疆医科大学附属肿瘤医院收治的经根治性手术后出现颈部淋巴转移的18例宫颈鳞癌患者与同期术后未发现复发转移的72例宫颈鳞癌患者的临床病理特征,对颈部淋巴结转移的危险因素及预后采用COX回归进行多因素分析和Kaplan-Meier方法生存率分析。结果 546例ⅠB～ⅡB宫颈鳞癌术后颈部淋巴结出现转移18例,转移率约为3.3%。治疗前肿瘤直径≥4cm、髂总淋巴结阳性、脉管有癌栓是颈部淋巴结转移独立的危险因素。治疗前血清鳞状上皮细胞癌抗原(SCC-Ag)水平≥2ng/L、宫颈浸润深度≥1/2和是否颈部淋巴结转移是影响宫颈鳞癌患者预后的影响因素。颈部淋巴结转移的宫颈鳞癌患者3年生存率为43.3%,明显低于对照组的95.2%(P<0.05)。结论颈部淋巴结转移的宫颈鳞癌患者预后差。
Objective To investigate the risk factors, distribution and influencing factors of cervical lymph node metastasis in patients with stage ⅠB ~ ⅡB cervical squamous cell carcinoma after operation. Methods The clinical data of 18 patients with cervical squamous cell carcinoma who had cervical lymph node metastasis after radical surgery and 72 patients with cervical squamous carcinoma who did not find recurrence and metastasis at the same period after the radical surgery were retrospectively analyzed from 2003 to 2010. At the same time, Pathological features, risk factors and prognosis of cervical lymph node metastasis using multivariate analysis of COX regression and Kaplan-Meier survival rate analysis. Results In 546 cases of ⅠB ~ ⅡB cervical squamous cell carcinoma, there were 18 cases of cervical lymph node metastasis, the transfer rate was about 3.3%. Tumor diameter ≥ 4cm before treatment, positive common iliac lymph nodes, vascular thrombosis is an independent risk factor for cervical lymph node metastasis. Before treatment, the level of SCC-Ag≥2ng / L, the depth of cervical invasion≥1 / 2 and the cervical lymph node metastasis were the influencing factors for the prognosis of patients with cervical squamous cell carcinoma. The 3-year survival rate of cervical squamous cell carcinoma with cervical lymph node metastasis was 43.3%, which was significantly lower than that of the control group (95.2%, P <0.05). Conclusion The prognosis of cervical squamous cell carcinoma with cervical lymph node metastasis is poor.