宫颈癌淋巴结转移风险的临床及预后分析

目的:探索临床病理因素及血清肿瘤标志物与总体宫颈癌盆腔淋巴结转移的关系及淋巴结转移对预后的影响。方法:收集386例Ⅰa-Ⅱb期宫颈癌住院手术患者的临床资料，血清肿瘤标志物水平，对淋巴结转移及预后的高危因素进行单因素与多因素分析。结果:总体盆腔淋巴结转移率为25.0%（89/356）;肿瘤直径≥4cm（OR=2.778,95%CI:1.410-5.131,P=0.001），术前SSCAg水平>3ng/ml(OR=2.645,95%CI:1.106-4.673,P=0.019)是盆腔淋巴结转移的独立危险因素。病理类型（RR=3.638,95%CI:1.146-5.891,P=0.002）、FIGO分期（RR=2.672,95%CI:1.063-6.367,P=0.007）、SSCAg(RR=2.187,95%CI:1.121-4.287,P=0.001）对预后有影响。结论:肿瘤直径、术前SSCAg水平是盆腔淋巴结转移的独立危险因素，病理类型、FIGO分期及SSCAg水平是影响宫颈癌盆腔淋巴结转移患者预后的独立危险因素。

Risk factors and prognosis of lymph node metastasis analysis in patients with cervical cancer

Objective:To explore the role of clinicopathologic factors and serum tumor maker in lymph node metastasis and prognosis of cervical cancer patients.Methods:Clinical data and the level of serum tumor maker of 386 patients were analyzed.Results:The overall prevalence of level node metastasis was 25.0%（89/356）.In multi-factor Logistic analysis,tumor size（OR=2.778,95%CI:1.410-5.131,P=0.001） and SSCAg>3ng/ml before treatment (OR=2.645,95%CI:1.106-4.673,P=0.019) were associated with pelvic lymph node metastasis.According to Cox regression analysis,histological types（RR=3.638,95%CI:1.146-5.891,P=0.002） and FIGO stage （RR=2.672,95%CI:1.063-6.367,P=0.007）and SSCAg>3ng/ml before treatment (RR=2.187,95%CI:1.121-4.287,P=0.001）were related with prognosis of cervical cancer patients with lymph node metastasis.Conclusion:Tumor size and SSCAg>3ng/ml before treatment are independent risk factors for pelvic lymph node metastasis.Histological type,FIGO stage and SSCAg>3ng/ml before treatment are independent risk factors for prognosis incervical cancer with lymph node metastasis.