Herr Daniel, König Jochem, Heilmann Volker, Koretz Karin, Kreienberg Rolf, Kurzeder Christian
Department of Obstetrics and Gynecology, Ulm University Medical Center, Prittwitzstrasse 43, 89075, Ulm, Germany.
Ann Surg Oncol. 2009 Jan;16(1):128-32. doi: 10.1245/s10434-008-0185-7. Epub 2008 Nov 1.
Currently the prognostic value of lymphovascular space involvement (LVSI) in patients with cervical cancer is unclear. We evaluated the prognostic impact of different categories of LVSI on overall survival (OAS) and disease-free survival (DFS) in a Middle-European population of women with surgically staged, early cervical cancer. The records of 281 women with clinically and histologically diagnosed early cervical cancer undergoing primary surgical treatment at the University of Ulm School of Medicine between 1992 and 2006 were retrospectively reviewed. LVSI as determined by hematoxylin-eosin staining was topographically categorized as conjoined-LVSI and satellite-LVSI. The effect of LVSI, tumor stage, lymph node metastases, and histology on OAS and DFS was assessed by Cox regression analyses. Tumor size and nodal status could be confirmed as significant prognostic factors for OAS and DFS in early-stage cervical cancer. While no significant effect of LVSI in general (satellite-LVSI or conjoined-LVSI) on OAS and DFS was calculated, the presence of satellite-LVSI was associated with significant decreased rates of both, OAS and DFS. We propose satellite-LVSI as new risk factor for patients with early-stage cervical cancer, in order to better identify the patients urgently needing adjuvant therapy.
目前，宫颈癌患者中淋巴管间隙浸润（LVSI）的预后价值尚不清楚。我们评估了不同类型的LVSI对中欧地区手术分期为早期宫颈癌的女性患者总生存期（OAS）和无病生存期（DFS）的预后影响。回顾性分析了1992年至2006年间在乌尔姆大学医学院接受初次手术治疗的281例临床和组织学诊断为早期宫颈癌的女性患者的记录。通过苏木精-伊红染色确定的LVSI在地形学上分为连体LVSI和卫星LVSI。通过Cox回归分析评估LVSI、肿瘤分期、淋巴结转移和组织学对OAS和DFS的影响。肿瘤大小和淋巴结状态可被确认为早期宫颈癌OAS和DFS的重要预后因素。虽然总体上LVSI（卫星LVSI或连体LVSI）对OAS和DFS没有显著影响，但卫星LVSI的存在与OAS和DFS的显著降低率相关。我们提出卫星LVSI作为早期宫颈癌患者的新危险因素，以便更好地识别急需辅助治疗的患者。
