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[早期宫颈癌根治性子宫切除术后肺转移的临床病理特征及危险因素]

[Clinicopathologic characteristics and risk factors for lung metastasis after radical hysterectomy in early-stage cervical cancer].

作者信息

Zheng Aiwen, Chen Yaqing, Fang Jing, Zhang Yingli

机构信息

Department of Gynecologic Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China.

Department of Gynecologic Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China; Email:

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2015 Mar;50(3):204-9.

Abstract

OBJECTIVE

To discuss the clinicopathologic characteristics and risk factors for lung metastasis of early-stage cervical cancer after radical hysterectomy.

METHODS

The complete clinicopathologic data of patients with lung metastasis of cervical cancer after radical surgery from January 2008 to December 2013 admitted in Zhejiang Cancer Hospital were retrospectively analyzed by univariate and multivariate analysis.

RESULTS

(1) There were 38 cases of early cervical cancer suffered from lung metastasis after radical hysterectomy during the period. The median age at diagnosis of cervical cancer was 46 years, the average lung metastasis time was 13 months after operation, 50.0% (19/38) cases occurred in the first year. Thirty-one cases were squamous cell carcinoma and 7 cases were non-squamous cell carcinoma. (2) Univariate analysis showed that age, clinical stage, manner of tumor growth, tumor grade, perineuronal invasion, para-aortic lymph node metastasis were not significant effect on postoperative lung metastasis (all P>0.05). But tumor size, histologic types, depth of stromal invasion, uterine body infiltration, lympho-vascular space invasion,pelvic lymph node metastasis, positive margin and abnormal tumor markers were significantly correlated with postoperative lung metastasis (all P<0.05). Multivariate analysis showed that only tumor size, histologic types and pelvic lymph node metastasis were independent risk factors for lung metastasis of cervical cancer (P<0.05).

CONCLUSIONS

Patients of early-stage cervical cancer with lung metastasis mostly occurs within 1 year after radical hysterectomy. Local large tumor lesions (tumor size >4 cm), non-squamous cell carcinoma and pelvic lymph node metastasis were more likely to have lung metastasis.

摘要

目的

探讨早期宫颈癌根治术后肺转移的临床病理特征及危险因素。

方法

回顾性分析2008年1月至2013年12月在浙江省肿瘤医院收治的宫颈癌根治术后发生肺转移患者的完整临床病理资料,并进行单因素和多因素分析。

结果

(1)该时期有38例早期宫颈癌根治术后发生肺转移。宫颈癌诊断时的中位年龄为46岁,平均肺转移时间为术后13个月,50.0%(19/38)的病例发生在第1年。31例为鳞状细胞癌,7例为非鳞状细胞癌。(2)单因素分析显示,年龄、临床分期、肿瘤生长方式、肿瘤分级、神经周围浸润、腹主动脉旁淋巴结转移对术后肺转移无显著影响(均P>0.05)。但肿瘤大小、组织学类型、间质浸润深度、子宫体浸润、脉管间隙浸润、盆腔淋巴结转移、切缘阳性及肿瘤标志物异常与术后肺转移显著相关(均P<0.05)。多因素分析显示,仅肿瘤大小、组织学类型和盆腔淋巴结转移是宫颈癌肺转移的独立危险因素(P<0.05)。

结论

早期宫颈癌肺转移患者多在根治术后1年内发生。局部肿瘤病灶较大(肿瘤大小>4 cm)、非鳞状细胞癌及盆腔淋巴结转移者更易发生肺转移。

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