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目的探讨宫颈癌盆腔淋巴结转移的高危因素及对预后的影响,提高生存率。方法回顾分析1995年1月至2011年6月在首都医科大学附属北京妇产医院经根治性手术治疗550例Ⅰ~ⅡA2期宫颈癌,盆腔淋巴结转移的相关危险因素及预后。结果 64例宫颈癌有盆腔淋巴结转移,无淋巴结转移者5年生存率92.2%,有转移者5年生存率51.6%(P<0.05)。单因素分析,淋巴结转移与临床分期、组织学分级、肿瘤最大径线、宫颈深间质浸润、宫旁浸润、脉管间隙浸润相关(P<0.05);宫旁组织浸润、转移淋巴结部位、阴道切缘状况、转移淋巴结数量、转移淋巴结组数,是有盆腔淋巴结转移宫颈癌预后的重要因素(P<0.05)。多因素分析宫颈深间质浸润(P=0.001)和脉管间隙浸润(P=0.000)是影响宫颈癌淋巴结转移的独立危险因素;转移淋巴结组数2(P=0.000)是影响有淋巴结转移宫颈癌预后的独立危险因素。结论宫颈深间质浸润、脉管间隙浸润是影响宫颈癌盆腔淋巴结转移的独立高危因素;转移淋巴结组数≥2是有淋巴结转移宫颈癌影响预后的独立危险因素。
Objective To investigate the risk factors of pelvic lymph node metastasis and prognosis of cervical carcinoma and to improve the survival rate. Methods From January 1995 to June 2011, we analyzed the related risk factors and prognosis of 550 cases of stage Ⅰ ~ ⅡA2 cervical cancer and pelvic lymph node metastasis in Beijing Maternity Hospital Affiliated to Capital Medical University from January 1995 to June 2011. Results 64 cases of cervical cancer had pelvic lymph node metastasis, 5-year survival rate without lymph node metastasis was 92.2%, and 5-year survival rate with metastasis was 51.6% (P <0.05). Univariate analysis, lymph node metastasis and clinical stage, histological grade, maximum diameter of tumor, cervical deep stromal infiltration, uterine infiltration, vascular interstitial infiltration (P <0.05); paracancerous tissue infiltration, lymph node metastasis, vaginal The status of margins, the number of metastatic lymph nodes and the number of metastatic lymph nodes were important prognostic factors for pelvic lymph node metastasis of cervical cancer (P <0.05). Multivariate analysis showed that cervical stromal invasion (P = 0.001) and vascular interstitial infiltration (P = 0.000) were independent risk factors for cervical lymph node metastasis. The number of metastatic lymph nodes 2 (P = 0.000) Independent prognostic risk factors. Conclusion Cervical deep interstitial infiltration and vascular interstitial infiltration are independent risk factors for cervical lymph node metastasis. The number of metastatic lymph nodes ≥ 2 is an independent risk factor for prognosis of cervical cancer with lymph node metastasis.