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目的:回顾性研究探讨早期宫颈癌的临床病理特点、预后影响相关因素及淋巴结转移的高危因素。方法:选择1999年1月至2005年1月在中山大学肿瘤防治中心妇科住院治疗的、经病理确诊的314例早期(Ⅰb～Ⅱa期)宫颈癌临床病例资料进行回顾性分析,分析影响其预后及淋巴结转移的高危因素。结果:314例病例5年生存率为88.0%,复发率为13.4%。单因素分析显示深肌层浸润、脉管内瘤栓、淋巴结转移为总生存时间不良因素(P<0.05)。Cox回归分析显示淋巴结转移、深肌层浸润是预后的独立危险因素(P<0.05)。盆腔淋巴结转移组数≥3组与盆腔淋巴结转移组数<3组的生存时间有统计学差异(P=0.032)。单因素分析示SCCAg、FIGO分期、肿瘤直径、深肌层浸润、脉管内瘤栓、宫旁组织浸润均与盆腔淋巴结转移有关(P<0.05)。Logistic回归多因素分析:治疗前SCCAg>3 ng/mL(P<0.001,OR=4.966)、深肌层浸润(P=0.001,OR=5.503)与盆腔淋巴结转移有关。结论:淋巴结转移、深肌层浸润是宫颈癌预后的独立危险因素:治疗前SCCAg>3 ng/mL、深肌层浸润是盆腔淋巴结转移的独立危险因素。
Objective: To retrospectively study the clinical and pathological characteristics of early cervical cancer, prognostic factors and risk factors for lymph node metastasis. Methods: A retrospective analysis was performed on 314 cases of early stage (stage Ⅰb-Ⅱa) cervical cancer diagnosed by gynecology hospitalized in Sun Yat-sen University Cancer Center from January 1999 to January 2005, and the prognosis And lymph node metastasis risk factors. Results: The 5-year survival rate was 88.0% in 314 cases and the recurrence rate was 13.4%. Univariate analysis showed that deep myometrial invasion, vascularization tumor plugs and lymph node metastasis were the adverse factors of total survival time (P <0.05). Cox regression analysis showed lymph node metastasis, deep myometrial invasion is an independent risk factor for prognosis (P <0.05). The survival time of pelvic lymph node metastasis group ≥3 group and pelvic lymph node metastasis group <3 group were statistically different (P = 0.032). Univariate analysis showed that SCCAg, FIGO staging, tumor diameter, deep myometrial invasion, vascular embolism, parametrial invasion were associated with pelvic lymph node metastasis (P <0.05). Logistic regression multivariate analysis showed that SCCAg> 3 ng / mL before treatment (P <0.001, OR = 4.966) and deep myometrial invasion (P = 0.001, OR = 5.503) were associated with pelvic lymph node metastasis. CONCLUSIONS: Lymph node metastasis and deep myometrial invasion are independent risk factors for prognosis of cervical cancer. SCCAg> 3 ng / mL before SCI is an independent risk factor for pelvic lymph node metastasis.