Kaspar H G, Dinh T V, Doherty M G, Hannigan E V, Kumar D
Department of Pathology, University of Texas Medical Branch, Galveston.
Obstet Gynecol. 1993 Feb;81(2):296-300.
To evaluate the prognostic significance of three-dimensional determination of tumor size in stage I cervical adenocarcinoma.
Tumor volume was measured using hematoxylin and eosin-stained sections of cone biopsy and hysterectomy specimens from 36 patients with stage I adenocarcinoma of the cervix. The volume was then correlated with pelvic lymphatic spread and clinical outcome.
The subjects were followed for a mean (+/- SEM) of 63 +/- 8 months. No recurrence or lymphatic seeding was encountered in the 22 tumors measuring no more than 500 mm3. Two of 25 tumors (8%) having up to 5 mm depth of stromal invasion had lymph node metastasis, one of which was 1.5 mm, compared with four of 11 (36%) in the group with deeper than 5 mm invasion (P < .02). The depth of stromal invasion predicted recurrence less significantly. Among the 25 tumors with up to 5 mm stromal invasion, two recurred, compared with three of 11 with more than 5 mm invasion (P < .1). Two women who had tumor volumes below 500 mm3 and depths of stromal invasion up to 8.5 mm were disease-free at 52 and 96 months of follow-up. On the other hand, tumors with 2.6 and 3.8 mm stromal invasion, but with volumes exceeding 500 mm3, recurred.
Tumor volume is a better predictor of pelvic lymph node metastasis and recurrence than is the depth of stromal invasion in stage I cervical adenocarcinoma.
评估I期宫颈腺癌肿瘤大小的三维测定对预后的意义。
使用苏木精和伊红染色的36例I期宫颈腺癌患者的锥形活检及子宫切除标本切片测量肿瘤体积。然后将体积与盆腔淋巴扩散及临床结果进行关联分析。
受试者平均随访（±标准误）63±8个月。22个体积不超过500立方毫米的肿瘤未出现复发或淋巴播散。25个间质浸润深度达5毫米的肿瘤中有2个（8%）发生淋巴结转移，其中1个浸润深度为1.5毫米，而间质浸润深度超过5毫米的11个肿瘤中有4个（36%）发生淋巴结转移（P<0.02）。间质浸润深度对复发的预测意义较小。在25个间质浸润深度达5毫米的肿瘤中，有2个复发，而间质浸润深度超过5毫米的11个肿瘤中有3个复发（P<0.1）。2名肿瘤体积小于500立方毫米且间质浸润深度达8.5毫米的女性在随访52个月和96个月时无疾病复发。另一方面，间质浸润深度为2.6毫米和3.8毫米但体积超过500立方毫米的肿瘤复发。
在I期宫颈腺癌中，肿瘤体积比间质浸润深度更能预测盆腔淋巴结转移和复发。
