基于倾向性得分匹配分析举宫器在腹腔镜宫颈癌根治术中对脉管癌栓阳性率的影响

目的探讨腹腔镜宫颈癌根治术中举宫器的应用对脉管癌栓阳性率的影响。方法纳入2018年11月至2021年3月接受腹腔镜子宫根治性切除术举宫法或免举宫法治疗宫颈癌的病人的临床资料，经过纳排标准筛选后纳入109例有效病人，其中举宫法组73例，免举宫法组36例，利用倾向性得分匹配，按1∶1进行配对后通过平衡病人组间差异。免疫组织化学法检测入组标本中CD34标记微血管密度（microvessel density，MVD）、D2-40标记微淋巴管密度（microlymphatic vessel density，MLVD）及脉管癌栓阳性率，分析2种手术方法对脉管癌栓阳性率的影响。结果经倾向性得分匹配后，2组各纳入23例病人，2组癌组织和癌旁组织脉管计数与脉管癌栓阳性率差异均无统计学意义（P>0.05）。结论在腹腔镜宫颈癌根治术中，术中有无举宫器的使用对癌和癌旁组织脉管阳性率无影响，使用举宫器安全可行。

Effect of uterine manipulator on the positive rate of vascular tumor thrombus in laparoscopic radical cervical cancer surgery based on propensity score matching

ObjectiveTo investigate the effect of uterine manipulator on the positive rate of vascular tumor thrombus in laparoscopic radical hysterectomy for cervical cancer.MethodsThe clinical data of patients with cervical cancer who underwent laparoscopic radical hysterectomy in our hospital from November 2018 to March 2021 were included.After the screening by inclusion and exclusion criteria, 109 effective patients were included, including 73 cases in the uterine manipulator group and 36 cases in the non-uterine manipulator group.Using propensity score matching as 1:1, the difference was balanced between patient groups.Immunohistochemical method was used to detect the CD34 labeled microvessel density (MVD), D2-40 labeled microlymphatic vessel density (MLVD) and the positive rate of vascular tumor thrombus.The effects of the two surgical methods on the positive rate of vascular tumor thrombus were analyzed.ResultsAfter propensity score matching, 23 patients were included in each group.There was no significant difference in vessel count and positive rate of vessel tumor thrombus in cancer tissues and adjacent tissues between the two groups (P>0.05).ConclusionsIn laparoscopic radical hysterectomy for cervical cancer, whether or not to use a uterine manipulator during the operation has no effect on the positive rate of vessels in cancer and adjacent tissues, and it is safe and feasible to use a uterine manipulator.