Yan Wenxing, Qiu Shuang, Ding Yaming, Zhang Qi, Si Lihui, Lv Sha, Liu Linlin
Radiotherapy Department of Oncology, Second Hospital of Jilin University.
Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.
Medicine (Baltimore). 2019 Oct;98(40):e17301. doi: 10.1097/MD.0000000000017301.
The metastasis of cervical carcinoma is associated with the lymphovascular spread. The primary objective of the present study was to determine the prognostic value of lymphovascular space invasion (LVSI) in patients with early-stage cervical cancer in Jilin, China.In this retrospective cohort study, patients with early-stage cervical cancer (stage IB-IIA) at the Second Hospital of Jilin University from February 2014 to December 2016 were included in the analysis. All included participants underwent radical hysterectomy with pelvic lymphadenectomy. LVSI was identified by hematoxylin and eosin (H&E) staining. The primary outcomes are overall survival (OS) and progression-free survival (PFS). Kaplan-Meier curves were used to calculate the patient's survival. Survival was compared using the log-rank test, while risk factors for the prognosis were assessed by Cox regression analysis.The incidence of LVSI was positively associated with the depth of stromal invasion (P = .009) and lymph node metastasis (LNM, P < .001). LVSI is an independent factor that affects OS (P = .009) and PFS (P = .006) in patients with early stage cervical cancer. LNM status is an independent factor that affects postoperative OS (P = .005).The incidence of lymphatic vessel infiltration is positively associated with the depth of stromal invasion and LNM. LVSI is an independent risk factor for the prognosis of early cervical cancer. The results suggest that further large-scale studies are needed to improve the treatment for patients with LVSI.
宫颈癌的转移与淋巴管扩散有关。本研究的主要目的是确定在中国吉林早期宫颈癌患者中淋巴管间隙浸润（LVSI）的预后价值。
在这项回顾性队列研究中，纳入了2014年2月至2016年12月在吉林大学第二医院就诊的早期宫颈癌（IB-IIA期）患者进行分析。所有纳入的参与者均接受了根治性子宫切除术及盆腔淋巴结清扫术。通过苏木精和伊红（H&E）染色确定LVSI。主要结局指标为总生存期（OS）和无进展生存期（PFS）。采用Kaplan-Meier曲线计算患者生存率。使用对数秩检验比较生存率，同时通过Cox回归分析评估预后的危险因素。
LVSI的发生率与间质浸润深度呈正相关（P = 0.009），与淋巴结转移（LNM，P < 0.001）呈正相关。LVSI是影响早期宫颈癌患者OS（P = 0.009）和PFS（P = 0.006）的独立因素。LNM状态是影响术后OS的独立因素（P = 0.005）。
淋巴管浸润的发生率与间质浸润深度和LNM呈正相关。LVSI是早期宫颈癌预后的独立危险因素。结果表明，需要进一步开展大规模研究以改善LVSI患者的治疗。
