Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Acta Obstet Gynecol Scand. 2012 Jul;91(7):802-9. doi: 10.1111/j.1600-0412.2012.01415.x. Epub 2012 May 18.
To study the distribution characteristics and risk factors of cervical cancer lymph node metastasis (LNM).
Retrospective study.
Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and Affiliated Hospital to Zunyi Medical College.
404 women diagnosed with cervical cancer FIGO stage Ib1-IIa who underwent primary radical surgery and 104 women with Ib2-IIb tumors treated with neoadjuvant chemotherapy (NACT) before surgery.
Clinicopathological data were collected and analyzed.
Incidence of infiltration, metastasis and pelvic LNM.
In women without NACT, the incidence of infiltration, metastasis and LNM was 7.2, 17.6 and 15.8%, respectively. Metastasis and LNM were significantly associated with advanced FIGO stage and poorer histological grade. The incidence of multiple metastatic lymph nodes (MLNs), bilateral LNM, skip LNM, LNM in primary group and LNM in secondary group was 6.2, 3.0, 6.2%, 11.4 and 4.5%, respectively. Of the 111 MLNs, 13 (11.7%) were common iliac lymph nodes. In the NACT group, infiltration, metastasis and LNM were observed in 10 (9.6%), 24 (23.1%) and 21 (20.1%) of 104 women, respectively. Metastasis and LNM were significantly correlated with moderate cell differentiation.
High LNM risk is expected in tumors of IIa stage or higher and in moderately differentiated tumors. Skip metastasis and common iliac LNM are relatively common and therefore should not be neglected. Our results suggest that standardized and complete pelvic lymph node dissection under surgery is an important measure to ensure a therapeutic effect.
研究宫颈癌淋巴结转移（LNM）的分布特征和危险因素。
回顾性研究。
华中科技大学同济医学院附属协和医院妇产科，遵义医科大学附属医院。
404 例经初治根治性手术治疗的FIGO 分期 Ib1-IIa 期宫颈癌患者和 104 例 Ib2-IIb 期宫颈癌患者行新辅助化疗（NACT）后手术。
收集并分析临床病理资料。
浸润、转移和盆腔 LNM 的发生率。
未行 NACT 的患者中，浸润、转移和 LNM 的发生率分别为 7.2%、17.6%和 15.8%。转移和 LNM 与 FIGO 分期较晚和组织学分级较差显著相关。多个转移性淋巴结（MLNs）、双侧 LNM、跳跃性 LNM、原发组 LNM 和继发组 LNM 的发生率分别为 6.2%、3.0%、6.2%、11.4%和 4.5%。在 111 个 MLNs 中，13 个（11.7%）为髂总淋巴结。NACT 组中，104 例患者中有 10（9.6%）例出现浸润，24（23.1%）例出现转移，21（20.1%）例出现 LNM。转移和 LNM 与中等细胞分化显著相关。
Ⅱa 期及以上和中分化肿瘤 LNM 风险较高。跳跃性转移和髂总淋巴结转移较为常见，不容忽视。我们的研究结果表明，手术中进行标准化和完整的盆腔淋巴结清扫是保证治疗效果的重要措施。
