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目的通过探讨宫颈癌宫旁浸润(parametrial infiltration)及脉管浸润(lymph-vascular space invasion,LVSI)与宫颈癌分期及其他临床病理因素的关系,为提高分期诊断符合率、判断预后提供依据。方法对2005年1月至2007年7月期间四川大学华西第二医院收治的546例子宫颈鳞癌(squamous carcinoma of the cervix,SCC)的临床资料进行回顾性分析,对宫旁和脉管浸润与分期及其他临床、病理因素的关系进行相关分析。结果临床分期中Ⅱb期手术前后诊断符合率(15.9%)最低;脉管浸润的发生随手术病理分期的升高而增加,两者有相关性;单因素分析示宫旁浸润与肿瘤类型、浸润深度、淋巴结转移有关,脉管浸润与肿瘤类型、浸润深度、淋巴结转移、宫旁浸润有关;多因素分析示肿瘤类型和淋巴结转移与宫旁浸润有关,与脉管浸润相关的因素有肿瘤类型、浸润深度和淋巴结转移。结论宫旁浸润是临床分期的难点,脉管浸润能更早地提示淋巴结转移的潜在危险,两者均可通过对内生型肿瘤及淋巴结转移的识别来协助判断。
Objective To investigate the relationship between parametrial infiltration and lymph-vascular space invasion (cervical squamous cell carcinoma) and cervical cancer staging and other clinicopathological factors in order to provide a basis for improving the coincidence rate of staging diagnosis and prognosis. Methods The clinical data of 546 cases of squamous carcinoma of the cervix (SCC) admitted to the Second West China Hospital of Sichuan University from January 2005 to July 2007 were analyzed retrospectively. The changes of uterine and vascular infiltration and Staging and other clinical, pathological factors related to the analysis. Results The coincidence rate (15.9%) of the preoperative and postoperative Ⅱb stages in clinical staging was the lowest. The incidence of vascular infiltration increased with the increase of operative staging. There was a correlation between the two. The univariate analysis showed that paracancerous infiltration and tumor type, Depth, lymph node metastasis, vascular invasion and tumor type, depth of invasion, lymph node metastasis, uterine infiltration; multivariate analysis showed that the type of tumor and lymph node metastasis associated with uterine infiltration, and vascular invasion related factors are tumor type, Invasion depth and lymph node metastasis. Conclusion The parametrial infiltration is a difficult clinical stage. Vascular infiltration can prompt the potential risk of lymph node metastasis earlier, both of which can help to judge the endogenous tumor and lymph node metastasis.