Wu Chunchun, Li Lichun, Xiao Xue, Sun Anyi, Lin Wenji, Li Ailu
Department of Obstetrics and Gynecology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou Fujian Province 362000 PR China.
Department of Obstetrics and Gynecology, Medical College of Nanchang University, 330031 Nanchang PR China.
Open Life Sci. 2019 Jun 24;14:208-213. doi: 10.1515/biol-2019-0023. eCollection 2019 Jan.
To explore the risk factors related to regional lymph node metastasis in cervical cancer and analyze the value of independent risk factors in predicting regional lymph node metastasis.
We retrospectively analyzed the clinical data of 699 patients who underwent surgery for stage IB1-IIA2 cervical cancer in Quanzhou First Hospital affiliated to Fujian Medical University from 2010 to 2016. The patients were divided into metastasis ( = 92) and non-metastasis ( = 607) groups based on the postoperative pathology of regional lymph node status. The relevant clinicopathological features of the metastasis and non-metastasis groups were compared through variance analysis and chi-square tests. Logistic regression was adopted to screen relevant independent risk factors of regional lymph node metastasis.
In univariate analysis, International Federation of Gynecology and Obstetrics (FIGO) stages, serum squamous cell carcinoma antigen (SCC-Ag), histological type of squamous carcinoma and maximal tumor diameter were related factors for lymphatic metastasis in patients with cervical cancer. In multivariate analysis, SCC-Ag and histological type of squamous carcinoma were independent prognostic factors for lymphatic metastasis in patients with cervical cancer. Pre-treatment SCC-Ag serum levels, as a predictor of lymph node metastasis of cervical cancer, revealed a sensitivity of 62.07% (95% confidence interval (CI): 51.03-72.62%), specificity of 65.15% (59.07-70.89%), and area under the receiver operating characteristic (ROC) curve of 0.69 (95% CI: 0.61-0.76).
Cervical cancer patients whose pathological type is squamous carcinoma with high levels of SSC-Ag pre-operation are more likely to be diagnosed with regional lymph node metastasis. Standardized lymph node dissection should be implemented during operation.
探讨宫颈癌区域淋巴结转移的相关危险因素，并分析独立危险因素在预测区域淋巴结转移中的价值。
回顾性分析2010年至2016年在福建医科大学附属泉州第一医院接受手术治疗的699例IB1-IIA2期宫颈癌患者的临床资料。根据区域淋巴结状态的术后病理将患者分为转移组（n = 92）和非转移组（n = 607）。通过方差分析和卡方检验比较转移组和非转移组的相关临床病理特征。采用Logistic回归筛选区域淋巴结转移的相关独立危险因素。
单因素分析中，国际妇产科联盟（FIGO）分期、血清鳞状细胞癌抗原（SCC-Ag）、鳞状细胞癌组织学类型和最大肿瘤直径是宫颈癌患者淋巴转移的相关因素。多因素分析中，SCC-Ag和鳞状细胞癌组织学类型是宫颈癌患者淋巴转移的独立预后因素。术前SCC-Ag血清水平作为宫颈癌淋巴结转移的预测指标，敏感性为62.07%（95%置信区间（CI）：51.03-72.62%），特异性为65.15%（59.07-70.89%），受试者操作特征（ROC）曲线下面积为0.69（95%CI：0.61-0.76）。
术前病理类型为鳞状细胞癌且SSC-Ag水平高的宫颈癌患者更易被诊断为区域淋巴结转移。手术中应实施标准化淋巴结清扫。
