Yan Ming, Zhang Yan-Na, He Jie-Hua, Sun Jin-Rui, Sun Xue-Ming
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, PR China.
Chin J Cancer. 2010 Apr;29(4):425-30. doi: 10.5732/cjc.009.10528.
In the past decade, no remarkable improvement has been made in the 5-year survival of cervical cancer patients. This study was to explore the influence of lymph vascular space invasion (LVSI) on the prognosis of patients with early-stage cervical squamous cell carcinoma.
A total of 111 eligible patients with FIGO stage IB and IIA cervical squamous cell carcinoma underwent radical hysterectomy and pelvic lymphadenectomy at Sun Yat-sen University Cancer Center between January 1995 and December 2002. The histopathological slides of the 111 patients were reviewed by a senior gynecological pathologist. LVSI, invasion depth, tumor differentiation and lymph node metastasis were evaluated.
LVSI was present in 62 patients. The univariate analysis showed that the risk factors of overall survival (OS) included positive LVSI (P = 0.019) and lymph node metastasis (P = 0.002), while the risk factors of progression-free survival (PFS) included LVSI (P = 0.029), lymph node metastasis (P = 0.002), SccAg value (P = 0.018), invasion depth (P = 0.022) and positive surgical margin (P = 0.002). The multivariate analysis showed that lymph node metastasis was the independent prognostic factor of OS (P = 0.015), while lymph node metastasis and positive surgical margin were the independent factors of PFS (P = 0.006, P = 0.006). LVSI was correlated with lymph node metastasis (P = 0.011).
Whether LVSI is an independent prognostic factor of early-stage cervical squamous cell carcinoma cannot be determined currently while LVSI is a risk factor of metastasis and relapse.
在过去十年中,宫颈癌患者的5年生存率并无显著提高。本研究旨在探讨淋巴管间隙浸润(LVSI)对早期宫颈鳞状细胞癌患者预后的影响。
1995年1月至2002年12月期间,共有111例符合条件的国际妇产科联盟(FIGO)分期为IB和IIA期的宫颈鳞状细胞癌患者在中山大学肿瘤防治中心接受了根治性子宫切除术和盆腔淋巴结清扫术。由一位资深妇科病理学家对这111例患者的组织病理切片进行复查。评估LVSI、浸润深度、肿瘤分化程度及淋巴结转移情况。
62例患者存在LVSI。单因素分析显示,总生存(OS)的危险因素包括LVSI阳性(P = 0.019)和淋巴结转移(P = 0.002),而无进展生存(PFS)的危险因素包括LVSI(P = 0.029)、淋巴结转移(P = 0.002)、鳞状细胞癌抗原(SccAg)值(P = 0.018)、浸润深度(P = 0.022)及手术切缘阳性(P = 0.002)。多因素分析显示,淋巴结转移是OS的独立预后因素(P = 0.015),而淋巴结转移和手术切缘阳性是PFS的独立因素(P = 0.006,P = 0.006)。LVSI与淋巴结转移相关(P = 0.011)。
目前尚不能确定LVSI是否为早期宫颈鳞状细胞癌的独立预后因素,而LVSI是转移和复发的危险因素。