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目的探讨宫颈腺癌及鳞癌手术患者盆腔淋巴结分布及转移的特点差异。方法回顾性分析569例广泛子宫切除及盆腔淋巴结清扫术宫颈癌患者的临床及病理资料。结果宫颈腺癌患者的淋巴结转移率(43.96%)明显高于鳞癌(20.30%);腺癌患者出现更高的高位淋巴结(髂总)转移(P<0.05)。腺癌患者表现出更高比例的多组转移(26.7%vs 9.05%)和双侧转移(11.2%vs 6.8%)(P<0.05)。腺癌患者有着更高的低期别转移率,ⅠB1、ⅠB2期转移率分别为43.28%、56.25%,明显高于鳞癌(P<0.05);而高期别鳞癌如ⅡA2期转移率为55.56%,与腺癌相近。结论宫颈腺癌的淋巴结转移率显著高于鳞癌,腺癌组患者发生高位转移、多站转移、双侧转移的比例高于鳞癌组,腺癌患者比鳞癌患者更易发生早期别淋巴结转移。
Objective To investigate the differences of the distribution and metastasis of pelvic lymph nodes between cervical adenocarcinoma and squamous cell carcinoma patients. Methods A retrospective analysis of 569 cases of extensive hysterectomy and pelvic lymphadenectomy in patients with cervical cancer clinical and pathological data. Results The rate of lymph node metastasis (43.96%) in patients with cervical adenocarcinoma was significantly higher than that in squamous cell carcinoma (20.30%). The patients with adenocarcinoma had higher lymph node metastases (P <0.05). Adenocarcinomas showed a higher proportion of multiple metastases (26.7% vs 9.05%) and bilateral metastasis (11.2% vs 6.8%) (P <0.05). Patients with adenocarcinoma had a higher rate of low-grade metastases, and the rates of metastases of stage ⅠB1 and stage ⅠB were 43.28% and 56.25%, respectively, which were significantly higher than those of squamous cell carcinoma (P <0.05) 55.56%, similar to adenocarcinoma. Conclusion The rate of lymph node metastasis of cervical adenocarcinoma is significantly higher than that of squamous cell carcinoma. The proportion of high metastasis, multi-metastasis and bilateral metastasis in adenocarcinoma group is higher than that in squamous cell carcinoma group. The patients with adenocarcinoma are more likely to have early lymph node metastasis than squamous cell carcinoma .