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目的探讨根治性宫颈癌手术患者盆腔淋巴结转移和5年生存率的影响因素。方法选择2007年1月—2012年12月嘉兴市妇幼保健院宫颈癌Ⅰa~Ⅱb期手术患者225例作为研究对象,收集患者的临床病理资料。结果 225例宫颈癌患者中淋巴结转移者54例,转移率为24.0%。治疗前血红蛋白水平<110 g/L、FIGO分期Ⅱ期、肌层浸润深度≥1/2、有宫旁浸润、有淋巴血管间隙侵犯、肿瘤直径≥4 cm的淋巴结转移率高于治疗前血红蛋白水平≥110 g/L、FIGO分期Ⅰ期、肌层浸润深度<1/2、无宫旁浸润、无淋巴血管间隙侵犯、肿瘤直径<4 cm者(P<0.05)。治疗前血红蛋白水平、FIGO分期、宫旁浸润、淋巴血管间隙侵犯、肿瘤直径为宫颈癌淋巴结转移的独立影响因素(P<0.05)。宫颈癌患者的5年生存率为83.7%。年龄≥45岁、治疗前血红蛋白水平<110 g/L、FIGO分期Ⅱ期、肌层浸润深度≥1/2、有宫旁浸润、有淋巴血管间隙侵犯、肿瘤直径≥4 cm、非鳞癌、有淋巴结转移患者的5年生存率低于年龄<45岁、治疗前血红蛋白水平≥110 g/L、FIGO分期Ⅰ期、肌层浸润深度<1/2、无宫旁浸润、无淋巴血管间隙侵犯、肿瘤直径<4 cm、鳞癌、无淋巴结转移患者的5年生存率(P<0.05)。治疗前血红蛋白水平、淋巴血管间隙侵犯、非鳞癌和淋巴结转移是宫颈癌患者5年生存率的独立影响因素(P<0.05)。结论治疗前血红蛋白水平、FIGO分期、宫旁浸润、淋巴血管间隙侵犯、肿瘤直径为宫颈癌淋巴结转移的独立影响因素。治疗前血红蛋白水平、淋巴血管间隙侵犯、非鳞癌和淋巴结转移是宫颈癌患者预后的独立影响因素。
Objective To investigate the influencing factors of pelvic lymph node metastasis and 5-year survival rate in radical cervical cancer patients. Methods A total of 225 patients with stage Ⅰa ~ Ⅱb cervical cancer in Jiaxing Maternal and Child Health Care Hospital from January 2007 to December 2012 were selected as the research object to collect the clinical and pathological data of the patients. Results In the 225 cases of cervical cancer, 54 cases of lymph node metastasis, the transfer rate was 24.0%. Before treatment, the hemoglobin level was less than 110 g / L, the FIGO stage Ⅱ, the depth of myometrial invasion ≥1 / 2, infiltration of the uterus and lymphatic vascular space. The lymph node metastasis rate was higher than that of the pretreatment hemoglobin ≥110 g / L, FIGO staging Ⅰ, myometrial invasion depth <1/2, no paracarcinoma infiltration, non-invasion of lymphatic space and tumor diameter less than 4 cm (P <0.05). Pretreatment hemoglobin levels, FIGO stage, uterine infiltration, lymphatic vascular space invasion, tumor diameter were independent factors affecting cervical lymph node metastasis (P <0.05). The 5-year survival rate of cervical cancer patients was 83.7%. Age ≥45 years, pre-treatment hemoglobin level <110 g / L, FIGO stage Ⅱ, myometrial invasion depth ≥1 / 2, with uterine infiltration, lymphatic vascular space invasion, tumor diameter ≥ 4 cm, non-squamous cell carcinoma, The 5-year survival rate of patients with lymph node metastasis was lower than 45 years old before treatment, hemoglobin level before treatment ≥110 g / L, FIGO stage Ⅰ, myometrial invasion depth <1/2, without paracrine infiltration, non-lymphatic vascular space invasion , Tumor diameter <4 cm, squamous cell carcinoma without lymph node metastasis (P <0.05). Pretreatment hemoglobin levels, lymphatic vascular space invasion, non-squamous cell carcinoma and lymph node metastasis of cervical cancer patients 5-year survival rate of independent factors (P <0.05). Conclusion The hemoglobin level before treatment, FIGO stage, uterine infiltration, invasion of lymphatic vessels and the diameter of tumor are the independent influencing factors of cervical lymph node metastasis. Pretreatment hemoglobin levels, lymphatic vascular space invasion, non-squamous cell carcinoma and lymph node metastasis is an independent prognostic factor in patients with cervical cancer.