Hoorshad Niloufar, Zamani Narges, Sheikh Hasani Shahrzad, Poopak Amirhossein, Sharifi Amirsina
Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran.
Department of Gynecology Oncology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Ann Med Surg (Lond). 2022 Jun 20;79:104020. doi: 10.1016/j.amsu.2022.104020. eCollection 2022 Jul.
INTRODUCTION: There was an increase in number of patients presented with early-stage cervical cancer (CC). Tumors with favorable pathological features might be candidates for less radical surgery. METHODS: We retrospectively reviewed 700 patients with histologically confirmed CC between January 2011 and March 2020. Chi-square, Fisher's exact tests and multivariate logistic regression analysis were used to assess relations between parametrial involvement (PI) and clinic-pathological variables. RESULTS: Total number of 132 patients with stage IA to IIA were eligible to participate. Squamous cell carcinoma was reported in 100 (75.8%) patients, adenocarcinoma and other tumor pathologies were found in 24(18.2%) and 8(6.1%), respectively. Considering the 2018 FIGO stage, 11 (8.4%) patients had IA, 111 (83%%) IB and 10 (7.6%) IIA. Nine patients (6.8%) had PI on permanent pathologic report. Univariate analysis demonstrated that following variables were statistically different between patients with and without PI: age ≥50, tumor size ≥ 3 cm, lower segment involvement, poorly differentiated pathology, deep stromal invasion, pelvic lymph node, lympho-vascular involvement and positive surgical margin (all p values < 0.05). Among these variables only tumor size ≥3 cm (OR: 2.1, 95% CI: 1.11-4.16, p value: 0.02), deep stromal invasion (OR: 2.2, 95% CI: 1.9-7.43, p value: 0.02) and positive surgical margin (OR: 5.1, 95% CI: 3.97-11.15, p value: 0.008) were independent risk factor of PI in multivariate analysis. CONCLUSIONS: Early stage CC might be surgically approached in a more conservative manner if patients have tumor size <3 cm and do not have deep stromal invasion in conization.
引言:早期宫颈癌(CC)患者数量有所增加。具有良好病理特征的肿瘤可能适合进行不太激进的手术。 方法:我们回顾性分析了2011年1月至2020年3月期间700例经组织学确诊为CC的患者。采用卡方检验、Fisher精确检验和多因素逻辑回归分析来评估宫旁组织受累(PI)与临床病理变量之间的关系。 结果:共有132例IA期至IIA期患者符合参与条件。其中100例(75.8%)为鳞状细胞癌,24例(18.2%)为腺癌,8例(6.1%)为其他肿瘤病理类型。根据2018年国际妇产科联盟(FIGO)分期,11例(8.4%)为IA期,111例(83%)为IB期,10例(7.6%)为IIA期。9例(6.8%)患者的永久病理报告显示存在PI。单因素分析表明,有PI和无PI的患者在以下变量上存在统计学差异:年龄≥50岁、肿瘤大小≥3 cm、宫颈下段受累、病理分化差、深层间质浸润、盆腔淋巴结转移、淋巴血管浸润和手术切缘阳性(所有p值<0.05)。在多因素分析中,这些变量中只有肿瘤大小≥3 cm(比值比:2.1,95%置信区间:1.11 - 4.16,p值:0.02)、深层间质浸润(比值比:2.2,95%置信区间:1.9 - 7.43,p值:0.02)和手术切缘阳性(比值比:5.1,95%置信区间:3.97 - 11.15,p值:0.008)是PI的独立危险因素。 结论:如果患者肿瘤大小<3 cm且锥切术中无深层间质浸润,早期CC可能可以采用更保守的手术方式。
Ann Med Surg (Lond). 2022-6-20
Gynecol Oncol. 2017-4-6
Zhonghua Fu Chan Ke Za Zhi. 2005-4
J Gynecol Obstet Hum Reprod. 2021-10
J Obstet Gynaecol Res. 2019-3
Diagnostics (Basel). 2025-4-12
Int J Gynaecol Obstet. 2019-1-17
Int J Gynaecol Obstet. 2006-11
Arch Gynecol Obstet. 2018-3
Gynecol Oncol. 2017-4-6