探讨淋巴脉管间隙浸润对早期宫颈癌预后的影响

探讨淋巴脉管间隙浸润对早期宫颈癌预后的影响。查阅淋巴脉管间隙浸润(lymphovascular space invasion,LVSI)与早期宫颈癌相关文献,文献涉及早期宫颈癌保守性手术、根治术后长期随访观察LVSI与预后的影响。活检标本与根治术标本比较,分析其对淋巴转移、浸润深度的预测价值。共计34篇文献符合要求,部分文献显示淋巴脉管间隙浸润不是宫颈癌预后的独立危险因素,否定其作为早期宫颈癌保留生育功能的评价指标,而部分文献显示LVSI与预后相关。临床观察发现LVSI阳性患者保守性手术治疗仍应谨慎。淋巴脉管间隙浸润作为早期宫颈癌保留生育功能的评价指标尚存争议,其可能与淋巴转移有关,后者是宫颈癌不良预后的独立危险因素。

Prognostic impact of lymphovascular space invasion in women with early-stage cervical carcinoma

To determine whether lymphovascular space involvement (LVSI) in women with early cervical carcinoma is an independent prognostic factor,and how to deal with it. The literature was reviewed using Medline/Pubmed and known literature to determine if LVSI is an independent risk factor in patients with early-stage cervical carcinoma whether undergoing surgery or taking conservative treatment.A total of 34 articles were identified that satisfied the evaluation criteria; in ten LVSI was confirmed not to be an independent risk factor, and cannot be used as a criterion for reserving fertility in early cervical cancer. In 8 cases LVSI was identified to be related to the prognosis. Clinical observation showed that in LVSI-positive patients, conservative treatment need to be chosen with caution. Using LVSI as the independent determining factor for consideration of post radical hysterectomy radiotherapy appears questionable, and it may be related to lymph metastasis.