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目的:探讨早期宫颈鳞状细胞癌患者盆腔淋巴结转移的危险因素。方法:回顾分析152例行手术治疗的ⅠB~ⅡA期宫颈鳞癌患者的临床资料,分析患者的年龄、临床分期、肿瘤细胞分化程度、宫颈间质浸润深度、肿瘤直径大小、脉管癌栓、术前血清宫颈鳞状上皮抗原(SCC-Ag)水平、治疗前血浆纤维蛋白原(FⅠB)水平及D-二聚体水平9个指标与盆腔淋巴结转移的关系。结果:152例ⅠB~ⅡA期宫颈鳞癌患者中20例存在盆腔淋巴结转移(13.16%)。单因素分析结果显示,宫颈间质浸润深度、肿瘤直径、脉管癌栓、术前血清SCC-Ag水平及血浆FⅠB水平与盆腔淋巴结转移有关,差异有统计学意义(P<0.05);淋巴结阳性患者的血浆D-二聚体水平高于阴性患者,但差异无统计学意义(P>0.05)。多因素分析结果显示,脉管癌栓、术前血清SCC-Ag及血浆FⅠB水平与盆腔淋巴结转移相关,差异有统计学意义(P<0.05)。结论:脉管癌栓、术前血清SCC-Ag水平及治疗前血浆FⅠB水平是ⅠB~ⅡA期宫颈鳞癌患者盆腔淋巴结转移的独立危险因素,而术前D-二聚体水平与盆腔淋巴结转移之间的关系,尚需进一步研究。
Objective: To explore the risk factors of pelvic lymph node metastasis in patients with early cervical squamous cell carcinoma. Methods: The clinical data of 152 patients with stage ⅠB ~ ⅡA cervical squamous cell carcinoma who were surgically treated were retrospectively analyzed. The patients’ age, clinical stage, degree of tumor cell differentiation, depth of cervical interstitial infiltration, diameter of tumor, tumor embolism, Preoperative serum levels of cervical squamous cell carcinoma antigen (SCC-Ag), pre-treatment plasma fibrinogen (F Ⅰ B) levels and D-dimer levels in 9 patients with pelvic lymph node metastasis. Results: In 152 cases of ⅠB ~ ⅡA cervical squamous cell carcinoma in 20 cases of pelvic lymph node metastasis (13.16%). The results of univariate analysis showed that the depth of cervical interstitial infiltration, the diameter of tumor, the tumor thrombus, the level of preoperative serum SCC-Ag and the level of plasma FⅠB were correlated with pelvic lymph node metastasis (P <0.05). The lymph node positive Patients with plasma D-dimer levels higher than negative patients, but the difference was not statistically significant (P> 0.05). Multivariate analysis showed that the levels of vascular tumor thrombus, preoperative serum SCC-Ag and plasma F Ⅰ B were correlated with pelvic lymph node metastasis (P <0.05). Conclusions: Vascular cancer thrombus, preoperative serum SCC-Ag level and pre-treatment plasma F Ⅰ B level are independent risk factors for pelvic lymph node metastasis in stage ⅠB-ⅡA cervical squamous cell carcinoma, while the level of preoperative D-dimer and pelvic lymph node metastasis The relationship between the need for further study.