宫颈癌患者发生盆腔淋巴结转移独立危险因素分析

摘要

Objective To explore the independent risk factors of pelvic lymph node metastasis in patients with cervical cancer, and provide a reference for preoperative treatment and prognosis analysis of cervical cancer patients.Methods A total of180 patients with cervical cancer were enrolled and divided into two groups:154 patients in the non-metastasis group (no pelvic lymph node metastasis) and 26 patients in the metastatic group (pelvic lymph node metastasis).Independent risk factors for pelvic lymph node metastasis in patients with cervical cancer were analyzed by clinical and pathological data and multivariate logistic regression analysis.Results Univariate analysis showed that the age, clinical stage, tumor diameter, tumor infiltration depth, vascular tumor thrombus and parametrial infiltration in the metastatic group were significantly different from those in the non-metastasis group, and the difference was statistically significant (P＜0.05).However, the degree of differentiation, histological type, and preoperative chemotherapy were not found to be statistically significant (P＞0.05).Statistically significant factors in the univariate analysis were included in the multivariate analysis.Multivariate logistic regression analysis showed that tumor size, vascular tumor thrombus, depth of tumor invasion, and parametrial infiltration were independent risk factors for pelvic lymph node metastasis in women with cervical cancer.Conclusion Female patients with cervical cancer are prone to pelvic lymph node metastasis:tumor diameter≥4 cm, vascular tumor thrombus positive, tumor infiltration depth≥2/3 and tumor parametrial infiltration positive.Through the above analysis, it is of great significance for the preoperative treatment plan and prognosis analysis of patients with cervical cancer.%目的 探讨宫颈癌患者发生盆腔淋巴结转移的独立危险因素, 为宫颈癌患者的术前治疗方案以及预后分析提供一定的参考依据.方法 选取宫颈癌患者共180例为研究对象, 分为两组:未转移组 (未发生盆腔淋巴结转移) 154例和转移组 (发生盆腔淋巴结转移) 26例.通过临床病理资料整理, 采用多因素logistic回归分析, 探讨宫颈癌患者发生盆腔淋巴结转移的独立危险因素.结果 单因素分析结果显示:转移组年龄、临床分期、肿瘤直径大小、肿瘤浸润深度、脉管癌栓情况和肿瘤宫旁浸润情况与未转移组有显著不同, 差异具有统计学意义 (P＜0.05), 而分化程度、组织学类型、以及患者术前化疗情况尚未发现具有统计学差异 (P＞0.05) .将单因素分析中有统计学意义的因素纳入到多因素分析.通过多因素logistic回归分析, 结果显示:肿瘤直径大小、脉管癌栓情况、肿瘤浸润深度、以及肿瘤宫旁浸润情况是宫颈癌女性患者发生盆腔淋臣结转移的独立危险因素.结论 宫颈癌女性患者易发生盆腔淋巴结转移的情况有:肿瘤直径≥4 cm、脉管癌栓阳性、肿瘤浸润深度≥2/3以及肿瘤宫旁浸润阳性.通过以上情况分析, 对于宫颈癌患者的术前治疗方案以及预后分析有重要意义.