Pallavi V R, Devi K U, Mukherjee G, Ramesh C, Bafna U D
Department of Gynaecologic Oncology, Kidwai Memorial Institute of Oncology, Dr M. H. Marigowda Road, Bangalore, Karnataka, India.
J Obstet Gynaecol. 2012 Jan;32(1):78-80. doi: 10.3109/01443615.2011.625455.
A retrospective review of 360 cases of carcinoma of the cervix with clinical stage IB and IIA who had undergone radical hysterectomy and pelvic node dissection between 2000 and 2005 was carried out. Lymph node metastasis was present in 79/360 patients (21.9%). LVSI positivity, full thickness stromal invasion, involvement of the uterine isthmus, positive parametrium, positive vaginal margins, involvement of uterine corpus was seen in: 25.3% and 9.2% (p < 0.001); 63% and 32% (p < 0.001); 32.9% and 13.8% (p < 0.001);15.2% and 5% (p < 0.004); 24% and 14.2% (p < 0.005); 17.7% and 13.8% (p = 0.11) of the patients, with and without lymph node metastasis, respectively. The tumour size was <4 cm in 50.6% and 58.3% and >4 cm in 49.3% and 41.6% of the patients, with and without lymph node metastasis, respectively (p = 0.22), which was statistically not significant. In the majority of patients, the histopathology type was squamous cell carcinoma in both the groups. In patients with lymph node metastases 79.7% had grade III tumour as compared with 69.5% in patients without lymph node metastases (p = 0.19). Multiple logistic regression indicated that only lymphovascular space involvement and full thickness stromal invasion were statistically significant (p < 0.001 and p < 0.002, respectively) for lymph node metastasis.
对2000年至2005年间接受根治性子宫切除术和盆腔淋巴结清扫术的360例临床分期为IB和IIA期的宫颈癌病例进行了回顾性研究。360例患者中有79例（21.9%）出现淋巴结转移。在有和无淋巴结转移的患者中，分别有25.3%和9.2%（p<0.001）出现淋巴脉管间隙浸润阳性、25.3%和9.2%（p<0.001）出现全层间质浸润、32.9%和13.8%（p<0.001）出现子宫峡部受累、15.2%和5%（p<0.004）出现宫旁组织阳性、24%和14.2%（p<0.005）出现阴道切缘阳性、17.7%和13.8%（p=0.11）出现子宫体受累。肿瘤大小<4cm的患者在有和无淋巴结转移组中分别占50.6%和58.3%，肿瘤大小>4cm的患者在有和无淋巴结转移组中分别占49.3%和41.6%（p=0.22），差异无统计学意义。在大多数患者中，两组的组织病理学类型均为鳞状细胞癌。有淋巴结转移的患者中79.7%为III级肿瘤，无淋巴结转移的患者中这一比例为69.5%（p=0.19）。多因素logistic回归分析表明，只有淋巴脉管间隙受累和全层间质浸润对淋巴结转移具有统计学意义（分别为p<0.001和p<0.002）。
