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目的:探讨宫颈癌ⅠB~ⅡB期淋巴结转移的高危险因素以及转移途径,了解盆腔淋巴结的转移规律,为选择性淋巴结切除提供一定的依据。方法:对湖北省荆州市第一人民医院2000年1月~2007年10月的子宫颈癌ⅠB~ⅡB期291例住院手术患者的临床病理资料进行回顾性分析。结果:在291例患者中,盆腔淋巴结转移64例,淋巴结转移率为22.0%。转移部位以闭孔最多,占18.2%(53/291),其余依次为髂内4.8%(14/291)、髂总3.4%(10/291)、髂外3.1%(9/291)、腹股沟深淋巴结1.7%(5/291),宫旁淋巴结0.7%(2/291)。淋巴结转移与临床分期、间质浸润深度相关,而患者组织学病理分级、年龄、肿瘤大小、组织学类型与淋巴结转移无关。结论:闭孔淋巴结是子宫颈癌最常见转移部位,可能是宫颈癌的前哨淋巴结。宫颈癌患者的临床分期、间质浸润深度是影响宫颈癌盆腔淋巴结转移的重要因素,而对宫颈癌患者进行手术治疗时应充分考虑这些高危因素。
Objective: To investigate the high risk factors of cervical lymph node metastases of stage ⅠB ~ ⅡB and their metastatic pathways, to understand the regularity of pelvic lymph node metastasis and to provide a basis for the selective lymphadenectomy. Methods: The clinical and pathological data of 291 cases of inpatients with stage ⅠB ~ ⅡB cervical cancer from January 2000 to October 2007 in Jingzhou First People ’s Hospital of Hubei Province were retrospectively analyzed. Results: Among 291 patients, 64 cases had pelvic lymph node metastasis and the rate of lymph node metastasis was 22.0%. The most closed obturator was metastasis, accounting for 18.2% (53/291), followed by 4.8% (14/291) in iliac, 3.4% (10/291) in iliac, 3.1% (9/291) in external iliac, Deep lymph nodes 1.7% (5/291), parathyroid lymph nodes 0.7% (2/291). Lymph node metastasis and clinical stage, the depth of interstitial infiltration, and histopathological grading, age, tumor size, histological type and lymph node metastasis. Conclusion: Obturator lymph node is the most common metastatic site of cervical cancer, which may be sentinel lymph node of cervical cancer. Cervical cancer patients with clinical stage, the depth of interstitial infiltration of cervical cancer is an important factor affecting pelvic lymph node metastasis, and cervical cancer patients with surgical treatment should take full account of these risk factors.