Hoffman J S, Kumar N B, Morley G W
Obstet Gynecol. 1983 May;61(5):615-8.
All cases of stage I squamous cell carcinoma of the vulva from the University of Michigan Tumor Registry from 1935 to 1981 were reviewed. Seventeen of 90 (19%) patients had nodal metastases. All had a depth of invasion of more than 2 mm and all exhibited histologic confluence. The risk of nodal metastases varied with depth of invasion, size of lesion, and histologic grade, although the association with grade was not statistically significant. The size of the lesion influenced the incidence of nodal metastases only in that it was associated with the depth of invasion. Lymphovascular invasion was present in only four patients, but three of them had nodal metastases, including one patient with only 3 mm depth of invasion.
对密歇根大学肿瘤登记处1935年至1981年期间所有I期外阴鳞状细胞癌病例进行了回顾。90例患者中有17例（19%）发生淋巴结转移。所有患者的浸润深度均超过2mm，且均表现为组织学融合。尽管与分级的关联无统计学意义，但淋巴结转移风险随浸润深度、病变大小和组织学分级而异。病变大小仅通过与浸润深度相关而影响淋巴结转移发生率。仅4例患者存在淋巴管浸润，但其中3例有淋巴结转移，包括1例浸润深度仅3mm的患者。
