CAJ | 학술논문

背景与目的:近10年来,虽然宫颈癌治疗方法有所改进,但5年生存率无明显变化.本文通过回顾性研究来探讨淋巴脉管间隙浸润(lymph vascular space invasion,LVSI)对早期宫颈鳞癌预后的影响.方法:选取1995年1月至2002年12月在中山大学肿瘤防治中心初治为手术治疗的Ⅰ B+ⅡA期宫颈鳞状细胞癌病例111例,重新评价LVSI、肿瘤浸润深度、分化程度和淋巴结转移等因素,分析LVSI对早期官颈鳞癌预后的影响.LVSI是指在光学显微镜下在扁平的内皮细胞围绕成的间隙中看到至少一簇肿瘤细胞.采用SPSS13.0统计软件进行统计分析.结果:111例病例中LVSI阳性者为62例(55.9%).单因素分析表明LVSI阳性(P=0.019)和淋巴结转移(P=0.002)是总生存时间(overall survival,OS)的危险因素;LVSI阳性(P=0.029)、淋巴结转移(P=0.002)、SccAg(P=0.018)、浸润深度(P=0.022)和手术切缘阳性(P=0.002)是无进展生存时间(progression-free survival,PFS)的危险因素.多因素分析表明淋巴结转移是OS的独立预后因素(P=0.015);淋巴结转移和手术切缘阳性是PFS的独立预后因素(P=0.006,P=0.006).LVSI与淋巴结转移相关(P=0.011).结论:尚不能确定LVSI是早期宫颈鳞癌的独立预后因素.LVSI是转移和复发的危险因素.
배경여목적:근10년래,수연궁경암치료방법유소개진,단5년생존솔무명현변화.본문통과회고성연구래탐토림파맥관간극침윤(lymph vascular space invasion,LVSI)대조기궁경린암예후적영향.방법:선취1995년1월지2002년12월재중산대학종류방치중심초치위수술치료적Ⅰ B+ⅡA기궁경린상세포암병례111례,중신평개LVSI、종류침윤심도、분화정도화림파결전이등인소,분석LVSI대조기관경린암예후적영향.LVSI시지재광학현미경하재편평적내피세포위요성적간극중간도지소일족종류세포.채용SPSS13.0통계연건진행통계분석.결과:111례병례중LVSI양성자위62례(55.9%).단인소분석표명LVSI양성(P=0.019)화림파결전이(P=0.002)시총생존시간(overall survival,OS)적위험인소;LVSI양성(P=0.029)、림파결전이(P=0.002)、SccAg(P=0.018)、침윤심도(P=0.022)화수술절연양성(P=0.002)시무진전생존시간(progression-free survival,PFS)적위험인소.다인소분석표명림파결전이시OS적독립예후인소(P=0.015);림파결전이화수술절연양성시PFS적독립예후인소(P=0.006,P=0.006).LVSI여림파결전이상관(P=0.011).결론:상불능학정LVSI시조기궁경린암적독립예후인소.LVSI시전이화복발적위험인소.
Background and Objective: In the past decade,no remarkable improvement has been made in the 5-year survival of cervical cancer patients.This study was to explore the influence of lymph vascular space invasion(LVSI)on the prognosis of patients with early-stage cervical squamous cell carcinoma.Methods: A total of 111 eligible patients with FIGO stage ⅠB andⅡA cervical squamous cell carcinoma underwent radical hysterectomy and pelvic lymphadenectomy at Sun Yat-sen University Cancer Center between January 1995 and December 2002.The histopathological slides of the 111patients were reviewed by a senior gynecological pathologist.LVSI,invasion depth,tumor differentiation and lymph node metastasis were evaluated.Results: LVSI was present in 62 patients.The univariate analysis showed that the risk factors of overall survival(OS)included positive LVSI(P=0.019)and lymph node metastasis(P=0.002),while the risk factors of progression-free survival(PFS)included LVSI(P=0.029),lymph node metastasis(P=0.002),SccAg value(P=0.018),invasion depth(P=0.022)and positive surgical margin(P=0.002).The multivariate analysis showed that lymph node metastasis was the independent prognostic factor of OS(P=0.015),while lymph node metastasis and positive surgical margin were the independent factors of PFS(P=0.006,P=0.006).LVSI was correlated with lymph node metastasis(P=0.011).Conclusion: Whether LVSI is an independent prognostic factor of early-stage cervical squamous cell carcinoma cannot be determined currently while LVSI is a risk factor of metastasis and relapse.