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目的:分析宫颈鳞癌临床分期的准确性、淋巴结转移规律及与各临床病理因素的相关性,探讨淋巴结转移的高危因素及术前临床分期存在的问题和补充改进方法。方法:收集我院行根治性子宫切除+盆腔淋巴结清扫术508例临床ⅠA～ⅡB期宫颈鳞癌患者的临床病理资料,比较临床分期与手术-病理分期(pTNM)的结果,并分析临床病理因素与淋巴结转移之间的关系。结果:临床分期总的准确率为60.2%。单因素分析显示间质浸润深度、淋巴血管间隙浸润(LVSI)、临床分期、宫旁浸润、切缘浸润、阴道浸润、宫体浸润与淋巴结转移相关(P<0.05);多因素分析提示仅间质浸润深度、LVSI、临床分期与淋巴结转移相关(P<0.05)。结论:宫颈鳞癌临床分期的准确性欠佳,应用影像学检查(如MRI)等可能有助于提高分期准确率。间质浸润深度、LVSI、临床分期与淋巴结转移密切相关。
OBJECTIVE: To analyze the accuracy of clinical staging, lymph node metastasis and clinicopathological factors in cervical squamous cell carcinoma, and to explore the risk factors of lymph node metastasis and the existing problems in preoperative clinical staging as well as the supplementary methods. Methods: The clinical and pathological data of 508 patients with stage ⅠA ~ ⅡB cervical squamous cell carcinoma undergoing radical hysterectomy and pelvic lymph node dissection in our hospital were collected. The clinical stage and surgical-pathological stage (pTNM) were compared. The clinical and pathological factors Relationship with lymph node metastasis. Results: The total clinical staging accuracy rate was 60.2%. Univariate analysis showed that the depth of interstitial infiltration, lymphatic vascular space invasion (LVSI), clinical stage, paracancer infiltration, marginal infiltration, vaginal infiltration, uterine body infiltration and lymph node metastasis (P <0.05); multivariate analysis showed that only The depth of invasion, LVSI, clinical stage and lymph node metastasis (P <0.05). Conclusion: The accuracy of clinical staging of cervical squamous cell carcinoma is poor. Imaging diagnosis (such as MRI) may help to improve staging accuracy. The depth of interstitial infiltration, LVSI, clinical stage and lymph node metastasis are closely related.