E-cadherin increases squamous cell carcinoma antigen expression through phosphatidylinositol-3 kinase-Akt pathway in squamous cell carcinoma cell lines

Squamous cell carcinoma antigen (SCCA) has been used for the management of squamous cell carcinoma, especially for evaluating therapeutic effects and monitoring recurrence. It has been reported that SCCA has several biological activities and influences behavior of cancer cells. E-cadherin is a cell adhesion molecule and plays important roles in the process of cancer invasion and metastasis. Our previous studies have shown that blockage of E-cadherin action by anti-E-cadherin antibody treatment suppresses SCCA production in squamous cell carcinoma cells. This finding strongly suggests that E-cadherin regulates SCCA expression. The present study was, therefore, undertaken to investigate the correlation between E-cadherin and SCCA2. For this purpose, E-cadherin cDNA was transfected into squamous cell carcinoma cell lines, SiHa and SKG IIIa. Overexpression of E-cadherin increased SCCA2 expression together with cell aggregation. We also examined the involvement of phosphatidylinositol 3-kinase (PI3K)-Akt pathway, which is one of major signaling pathways from E-cadherin. E-cadherin transfection increased phosphorylated Akt expression concomitantly with the increase in SCCA2 expression, and the increased SCCA2 expression was inhibited by a PI3K inhibitor. In conclusion, SCCA2 is up-regulated by E-cadherin through PI3K-Akt pathway, suggesting that SCCA2, as well as E-cadherin, may be involved in the regulation of cancer behavior.     

子宫颈鳞状细胞癌中SCCA1和SCCA2的分子表达及其意义

 目的　探讨子宫颈鳞状细胞癌组织中SCCA1和SCCA2ｍRNA的表达在子宫颈鳞状细胞癌临床诊断、疗效评价及预后观察中的作用。方法　采用TaqMan探针实时聚合酶链反应（RT-PCR）的方法,分析60例子宫颈鳞状细胞癌患者和30例正常子宫颈组织中SCCA1和SCCA2 mRNA的表达。结果　SCCA2 mRNA在子宫颈鳞状细胞癌组织中较对照正常组织中表达水平高（相对表达量分别为4.405±2.310及9.088±2.195）,差异有统计学意义（t＝-6.513,P＜0.05）。SCCA1 mRNA则差异无统计学意义（t＝-0.115,P＞0.05）。SCCA2 mRNA的表达随着临床分期的增高而增高（F＝8.313,P＜0.05）,SCCA2 mRNA的表达在有淋巴结转移组较无淋巴结转移组高（t＝2.853,P＜0.05）,SCCA2 mRNA的表达与病理分级及患者年龄无关（P＞0.05）,SCCA1 mRNA的表达与患者年龄、病理分级、临床分期及淋巴结转移均无明显相关性（P＞0.05）。结论　SCCA2 mRNA的表达可能为子宫颈鳞状细胞癌临床分期、淋巴结转移的判断提供更为准确的信息。     

E-cadherin、PDPN、TLR4在舌鳞状细胞癌中的表达及其与淋巴结转移的相关性研究

目的 研究E-cadherin、PDPN、TLR4在舌鳞状细胞癌中的表达及与淋巴结转移的相关性.方法 选取82例舌鳞状细胞癌患者作为研究对象,检测舌鳞状细胞癌组织以及癌旁正常组织内粘附分子E(E-cadherin)、平足蛋白(PDPN)、Toll样受体4(TLR4)的表达,同时与患者临床特征进行分析.结果 E-cadh...     

E-cadherin和Vimentin表达与早期宫颈癌临床病理特征及预后的关系

目的 探讨早期宫颈鳞癌组织中上皮间质转化相关因子E-钙黏蛋白（E-cadherin）和波形蛋白（Vimentin）的表达与临床病理特征及预后的关系。方法 采用免疫组化SP法检测E-cadherin和Vimentin在50例Ⅰb～Ⅱa期宫颈鳞癌术后标本中的表达情况,分析两者与年龄、FIGO分期、分化程度、深肌层浸润、淋巴结转移、脉管瘤栓和宫旁浸润等临床病理特征的关系,并探讨其对预后的评估价值。结果 宫颈鳞癌组织中E-cadherin 高表达率为44.0％,Vimentin 阳性率为36.0％。E-cadherin表达与分化程度和脉管瘤栓密切相关（P＜0.05）,Vimentin表达与淋巴结转移情况和分化程度密切相关（P＜0.05）。单因素分析显示,宫颈鳞癌5年生存率与淋巴结转移、深肌层浸润及E-cadherin表达情况密切相关（P＜0.05）; Vimentin 阴性表达者的5年生存率高于阳性者（87.4％ vs. 72.2％）,差异无统计学意义（P＞0.05）。Cox多因素分析显示E-cadherin表达和淋巴结转移是影响早期宫颈癌患者5年生存率的独立因素（P＜0.05）。结论 E-cadherin和Vimentin表达程度与早期宫颈癌侵袭转移相关;E-cadherin表达、淋巴结转移是影响早期宫颈癌患者5年生存率的独立预后因素。     

The loss of E-cadherin, alpha- and beta-catenin expression is associated with metastasis and poor prognosis in invasive breast cancer

Loss of E-cadherin and catenin expression may be associated with distant and lymph node metastases in breast cancer. Heterogeneity of E-cadherin expression is associated with poor prognosis, suggesting that E-cadherin and catenins may serve as useful prognostic markers for invasive breast carcinoma. Reduction or loss of expression of either E-cadherin or catenins is associated with invasion, metastasis and poor prognosis in several types of human malignancies. We investigated the expression of E-cadherin, and alpha- and beta-catenins by immunohistochemistry in 171 cases of primary invasive breast cancer, and compared the expression with clinicopathological parameters to define the relationship between expression and prognosis. E-cadherin immunoreactive protein was shown to be expressed in 97 cases. Reduction or lack of expression of E-cadherin was associated with distant metastasis. Based on immunohistochemical heterogeneity, E-cadherin-positive tumors were classified into heterogeneous, homogeneous and intermediate types. Interestingly, although patients with heterogeneous type demonstrated the lowest incidence of distant metastasis at diagnosis, they showed a higher incidence of subsequent distant metastasis, after surgery, and a lower survival rate than those with homogeneous type (p<0.05). E-cadherin expression was reduced or negative in metastatic axillary lymph nodes regardless of the expression in the primary tumor, suggesting that changes in E-cadherin expression are associated with not only distant metastasis but also lymph node metastasis. Tumors negative for either alpha- or beta-catenin expression demonstrated a higher incidence of distant metastasis than those expressing both catenins, suggesting that the expression of catenins is involved in breast cancer metastasis. Reduction or loss of E-cadherin and catenin expression may be associated with distant and lymph node metastases in invasive breast cancer, and the heterogeneous type may be associated with poor prognosis.     

Suppression of SCC antigen promotes cancer cell invasion and migration through the decrease in E-cadherin expression

Squamous cell carcinoma antigen (SCCA) is a useful tumor marker for diagnosis and management of squamous cell carcinoma. Recent studies have shown that SCCA can influence the behavior of cancer cells. It is well known that cell-cell adhesion is an important factor for the progression of cancer. The present study, therefore, was undertaken to investigate the effect of SCCA2 on the cell adhesion related molecule, E-cadherin, and cancer cell behavior. For this purpose, antisense SCCA2 cDNA was transfected into human uterine cancer cell lines, SKG IIIa and SiHa, which express SCCA2. Suppression of SCCA2 expression by antisense SCCA2 cDNA transfection decreased E-cadherin expression and promoted cell migration and invasion as well as the blockage of E-cadherin function by anti-E-cadherin antibody administration. In conclusion, SCCA2 regulates cell migration and invasion via E-cadherin expression, suggesting that SCCA2 may be involved in cancer behavior such as invasion or metastasis.     

口腔鳞癌颈淋巴结转移的临床病理学特点及其对预后的影响

背景与目的口腔癌淋巴结转移率在50%～59%之间,对其处理好坏关系到患者的预后。本研究拟探讨影响口腔鳞癌颈淋巴结转移的临床病理因素及其对预后的影响。方法对191例口腔鳞癌患者的临床病理学因素与颈淋巴结转移的关系进行回顾性研究,并对颈淋巴结转移状态、转移颈淋巴结大小、转移颈淋巴结数目、转移颈淋巴结累及区域、转移颈淋巴结最低受累区域等淋巴结病理学因素对预后生存的影响进行Cox回归分析。结果口腔鳞癌患者5年生存率为48.7%。χ2分析显示,仅肿瘤浸润深度与发生颈淋巴结转移有关。Cox回归分析表明,临床N分期、颈淋巴结转移状态、转移颈淋巴结累及区域数、转移颈淋巴结最低受累区域因素影响患者预后,特别是临床N分期、转移颈淋巴结最低受累区域因素与口腔鳞癌患者预后明显相关。结论口腔鳞癌颈淋巴结转移是影响患者预后的重要因素,了解其颈淋巴结转移的规律,并对影响预后的淋巴结因素采取相应治疗措施,对提高口腔鳞癌治疗效果具有重要意义。     

上皮钙粘附素在宫颈鳞癌中的表达及临床意

 目的　研究上皮钙粘附素 (E- cadherin,ECD)在宫颈鳞癌中的表达及其临床意义。方法　采用 SP免疫组化染色方法 ,检测 42例宫颈鳞癌中 ECD的表达 ,并进行生存分析。结果　 (1 )宫颈鳞癌中 ECD有胞膜和胞浆两种表达形式。 、 级鳞癌中 ECD胞膜的高表达 (2 0 /31 )明显高于 级 (2 /1 1 ) (P<0 .0 5) ;淋巴结转移组 ECD胞浆的高表达 (1 1 /1 3)明显高于未转移组 (8/2 0 ) (P<0 .0 5)。 (2 ) ECD胞膜表达与胞浆表达呈显著负相关 (P<0 .0 1 )。 (3) ECD胞膜低表达或 /和胞浆高表达与细胞失分化、淋巴结转移及低生存率有关 (P<0 .0 5)。结论　 ECD胞膜低表达和 /或胞浆高表达是宫颈鳞癌不良预后的重要判断指标。     

Suppression of carbonyl reductase expression enhances malignant behaviour in uterine cervical squamous cell carcinoma: carbonyl reductase predicts prognosis and lymph node metastasis

Carbonyl reductase (CR) is an NADPH-dependent, mostly monomeric, cytosolic enzyme with broad substrate specificity for carbonyl compounds. CR appears to be involved in the regulation of tumour progression. However, molecular mechanisms of CR in tumour progression and clinical significance of CR status remain unclear in human uterine squamous cell carcinoma (SCC). Here, we investigated the clinical significance of CR using immunohistochemical analyses of human uterine cervical SCC tissues and how CR affects cancer cell behaviour in vitro. Paraffin sections from uterine cervical SCC tissues, FIGO stage Ib1-IIb (n = 67) were immunostained with anti-CR antibodies. Overall survival (OS) and progression-free survival (PFS) were analyzed by the Kaplan-Meier method. Sense and antisense CR cDNAs were transfected into a human uterine SCC cell line (SiHa) to investigate the role of CR in cancer cell invasion and metastasis. Immunohistochemical analyses showed that reduced CR expression patterns in primary cancer lesions were closely associated with a high incidence of pelvic lymph node metastasis, poor OS, and poor PFS. In an in vitro experiment, suppression of CR increased cancer cell invasion, secretion of MMP-2, -9 and cyclooxygenase-2 (COX-2) expression and decreased E-cadherin expression. On the other hand, over-expression of CR increased E-cadherin expression and decreased MMP-2, -9 secretion and COX-2 expression. The reduced CR expression pattern, as measured by immunohistochemistry, can be a useful predictor of lymph node metastasis and poor prognosis in patients with uterine SCC. This clinical result is supported by the in vitro data which show that suppression of CR expression promotes cancer cell invasion with decreased E-cadherin expression and increased MMP-2, -9 secretion.     

Expression of vascular endothelial growth factor, matrix metalloproteinase-9 and E-cadherin in the process of lymph node metastasis in oesophageal cancer.

Lymph node metastasis is a strong independent prognostic factor for oesophageal cancer. The expression of matrix metalloproteinases (MMPs) and reduction of E-cadherin correlate with lymph node metastasis of oesophageal cancer. We previously reported that the expression of vascular endothelial growth factor (VEGF) is associated with lymph node metastasis. This study was designed to determine whether VEGF, MMP-9 and E-cadherin expression is stable or changes in the process of lymph node metastasis of oesophageal cancer. Using immunohistochemistry, we detected VEGF, MMP-9 and E-cadherin expression in paraffin-embedded specimens of oesophageal squamous cell carcinoma. We classified 134 primary tumours and 174 nodal metastases using two different criteria: the absence [Group N(-)] or presence [Group N(+)] of nodal metastasis, and the stage of metastasis--Early Stage (cancer cells < 50% of lymph node) or Late Stage (> or = 50%)--and compared the expression among two groups and among two stages. The expression rates of Group N(-), Group N(+), Early Stage and Late Stage are as follows: VEGF (49%, 74%, 60%, 33%), MMP-9 (76%, 65%, 95%, 69%) and E-cadherin (49%, 24%, 55%, 38%). VEGF expression was down-regulated in Late Stage lymph node metastasis, while MMP-9 expression was elevated in Early Stage metastasis. E-cadherin expression is restored somewhat in Early Stage metastasis, but suppressed again in Late Stage metastasis. These data suggest that the expression of VEGF, MMP-9 and E-cadherin each change in the process of lymph node metastasis in oesophageal cancer, and that the patterns of change are different.     

Gli1蛋白及E-cadherin蛋白在宫颈癌中的表达及临床意义

目的:探讨Gli1蛋白及E-cadherin蛋白在宫颈癌中的表达及临床意义.方法:应用免疫组化SP法检测50例宫颈癌组织、30例宫颈上皮内瘤变(CIN)组织、40例正常组织中Gli1蛋白及E-cadherin蛋白的表达.结果:Gli1蛋白在宫颈癌组织中明显高于正常宫颈组织(P＜0.05),E-cadherin蛋白在宫颈癌组织中明显低于正常宫颈组织(P＜0.05).结论:Gli1蛋白的高表达及E-cadherin蛋白的低表达与宫颈癌的病理分级、临床分期、淋巴转移等密切相关,且两者在宫颈癌的表达呈负相关.     

Expression of thymidylate synthase and dihydropyrimidine dehydrogenase in primary oral squamous cell carcinoma and corresponding metastases in cervical lymph nodes: association with the metastasis suppressor CD82

Thymidylate synthase (TS) and dihydropyrimidine dehydrogenase (DPD) are 5-fluorouracil (5-FU) metabolizing enzymes and are involved in the sensitivity of carcinoma patients to 5-FU. Although 5-FU is often used for the treatment of oral carcinoma, there has not been any investigation into the expression of these enzymes in metastatic lymph nodes or of their roles in the effectiveness of 5-FU in treating lymph node-metastatic cancer. Oral squamous cell carcinoma (OSCC) often metastasizes to the lymph nodes, and these enzymes may be significant in the survival of patients with this disease. This study investigated the expression of TS and DPD in cervical lymph node metastases and its relationship with primary OSCC, as well as the interaction between these enzymes and Kangai 1(KAI1/CD82) which is a metastasis suppressor protein. Surgical specimens from 20 cases of OSCC with lymph node metastasis, 20 cases of OSCC without lymph node metastasis, and 10 cases of normal mucosa were examined by immunohistochemistry. The relationship between TS and DPD expression and clinicopathological data was analyzed. TS and DPD proteins were overexpressed in primary OSCC compared to that in normal mucosa. TS expression of the primary oral cancer cells in the group with lymph node metastasis was higher than that of those without. DPD expression did not significantly correlate with the occurrence of lymph node metastasis, nor was it different between primary oral cancer cells and cervical metastases. CD82 expression was significantly reduced in lymph node metastases. These findings indicate that TS and CD82 may be of great value in assessing lymph node metastasis of OSCC, and could be taken as new targets for therapy of metastatic OSCC.     

间隙连接蛋白43和E-钙黏素在肺癌组织中的表达及临床意义

  目的 探讨间隙连接蛋白（Cx43）和上皮细胞钙黏素（E-钙黏素）在非小细胞肺癌中的表达特征及其临床意义。方法 应用免疫组化ABC法检测50例原发性肺癌组织中Cx43和E-钙黏素的表达情况，分析其表达与肺癌临床病理的关系。结果 Cx43和E-钙黏素在非小细胞肺癌中的阳性表达率分别为54 %和46 %，20例癌旁组织中均可见E-钙黏素和Cx43阳性表达。随着肿瘤进展，Cx43和E-cadherin表达逐渐降低，在Ⅰ、Ⅱ期非小细胞肺癌中阳性表达率明显高于Ⅲ、Ⅳ期；中、高分化的肺癌阳性表达率明显高于低分化的肺癌；肺癌伴淋巴结转移者的E-钙黏素表达水平低于无淋巴结转移者；Cx43表达与肺癌有无淋巴结转移无明显相关性。Cx43在肺腺癌组织中的阳性表达率明显高于鳞癌和大细胞未分化癌（P＜0.05）。E-钙黏素的表达与非小细胞肺癌的组织类型无明显相关性。     

Kiss-1和E-cadherin在声门上型喉鳞状细胞癌中的表达及临床意义

目的观察Kiss-1和E钙粘蛋白(E-cadherin)在人声门上喉鳞状细胞癌组织中的表达及两者间的相互关系, 初步探讨Kiss-1、E-cadherin在人喉鳞状细胞癌发病机制中的作用及临床意义, 为喉鳞状细胞癌的预后判断提供理论依据。方法 应用免疫组化SP法检测78例声门上喉鳞状细胞癌及78例正常声门上喉组织的Kiss-1及E-cadherin蛋白的表达情况, 评估声门上喉鳞状细胞癌中Kiss-1及E-cadherin蛋白表达与临床及病理因素的关系, 并分析二者之间相关性。结果 Kiss-1和E-cadherin蛋白阳性表达主要位于细胞膜。78例声门上喉鳞状细胞癌组织中Kiss-1和E-cadherin蛋白的阳性表达率分别为32.1%和42.3%;78例喉正常组织中Kiss-1和E-cadherin蛋白的阳性表达率分别为62.8%和83.3%。两种抑癌基因在声门上喉鳞状细胞癌组织和正常喉组织中的表达有统计学差异(P＜0.01), Kiss-1和E-cadherin在喉鳞状细胞癌颈淋巴结转移、临床分期及分化程度具有统计学差异(P＜0.05), Kiss-1和E-cadherin在喉鳞状细胞癌的年龄、性别上无统计学差异(P＞0.05);Kiss-1和E-cadherin之间的表达呈正相关, 两者间差异具有统计学意义(P＜0.01)。结论 Kiss-1和E-cadherin蛋白在声门上喉鳞状细胞癌组织中的表达明显缺失, 提示Kiss-1和E-cadherin可能在喉鳞状细胞癌的发生发展中起重要作用;Kiss-1和E-cadherin蛋白表达与声门上喉鳞状细胞癌的淋巴结转移、临床分期及分化程度有关, 与患者的性别及年龄无关, Kiss-1和E-cadherin的表达存在相关性。     

HPV检测原发灶不明颈淋巴结转移癌的诊断作用初探(附6例报告)

目的 初步探讨HPV检测在诊断原发灶不明的颈淋巴结转移性鳞癌中的价值。方法 收集复旦大学附属肿瘤医院6例首诊为原发灶不明的颈淋巴结转移性鳞癌,最终确诊为HPV相关口咽鳞癌,分析确诊过程。结果 首诊时6例患者均被确诊为颈淋巴结转移性鳞癌,且p16表达阳性和HPV-16亚型阳性,而EBER表达阴性。经全面检查均未发现明显的原发病灶。随后对其中4例予同侧扁桃体盲检(2例)和切除(2例),病理均证实为扁桃体鳞癌。另2例分别在随访第149天、545天MRI检查发现同侧口咽侧壁和舌根增厚伴强化,经活检分别证实为扁桃体鳞癌、舌根鳞癌。结论 对于原发灶不明的HPV阳性颈淋巴结转移性鳞癌,应高度怀疑原发病灶来源于口咽部位的可能性,特别是扁桃体和舌根部位。     

E-cadherin、CD44V6和HLA-DR在非小细胞肺癌表达的临床意义

目的：探讨E-cadherin、CD44V6和HLA-DR抗原在非小细胞肺癌组织中的表达及其临床意义。方法：采用免疫组化ABC法，检测65例原发性非小细胞肺癌组织中E-cadherin、CD44V6和HLA-DR抗原表达情况，并分析了其表达与肺癌临床病理的关系。结果：65例肺癌组织中E．cadherin、CD44V6和HLA-DR的阳性表达率分别为53．8％(35／65)、58．5％(38／65)和53．8％(35／65)。E-cadherin、CD44V6表达与组织学类型无明显相关，与肺癌淋巴结转移密切相关。HLA-DR与组织学类型明显相关，与肺癌有无淋巴结转移无明显相关性。E-cadherin、CD44V6和HLA-DR阳性表达与病理分级及临床分期密切相关。结论：E-cadherin、CD44V6和HLA-DR异常表达在肺癌发生、发展和转移过程中起着重要作用，联合检测对判断肺癌生物学行为具有重要意义。     

The relationship between Bmi-1 and the epithelial–mesenchymal transition in lung squamous cell carcinoma

This study aimed to investigate the expression of Bmi-1 in lung squamous cell carcinoma tissues and the relationship between Bmi-1 and the epithelial-mesenchymal transition. RT-PCR and western blot analysis were performed to detect the expression of Bmi-1, E-cadherin, and Vimentin in 56 cases of lung squamous cell carcinoma tissues and adjacent normal tissues. The positive rates of Bmi-1, E-cadherin, and Vimentin mRNA expression in lung squamous cell carcinoma tissues were 73.2, 42.9, and 58.9%, respectively; compared to the expression of these genes in adjacent normal tissues (14.3, 75.0, and 28.6%), the differences were significant (P < 0.05). The expression of Bmi-1 in lung squamous cell carcinoma tissues showed a negative correlation with that of E-cadherin (r = -0.372, P = 0.005) and a positive correlation with that of Vimentin (r = 0.315, P = 0.02). The expression of Bmi-1 and Vimentin mRNA and protein in lung squamous cell carcinoma tissues was significantly higher than that in adjacent normal tissues (P < 0.05), and the expression of Bmi-1 and Vimentin in patients with lymph node and distal metastasis was significantly higher than that in patients without lymph node and distal metastasis (P < 0.05). The expression of E-cadherin mRNA and protein in lung squamous cell carcinoma tissues was significantly lower than that in adjacent normal tissues (P < 0.05), and the expression in patients with lymph node and distal metastasis was significantly lower than that in patients without lymph node and distal metastasis (P < 0.05). The expression of Bmi-1, E-cadherin, and Vimentin was not associated with the patient's sex, age, tumor size or degree of tumor differentiation (P > 0.05). The increase in Bmi-1 expression was accompanied by the down-regulation of E-cadherin expression and up-regulation of Vimentin expression. Bmi-1 may be associated with the epithelial-mesenchymal transition in lung squamous cell carcinoma and the occurrence, invasion, and metastasis of lung squamous cell carcinoma.     

E-钙黏蛋白在鼻咽癌组织中的表达水平及其与颈部淋巴结转移的关系

目的 探讨E-钙黏蛋白(E-cadherin)在鼻咽癌组织中的表达水平以及与鼻咽癌颈部淋巴结转移的关系.方法 应用免疫组织化学SP法,检测80例鼻咽癌组织中E-cadherin的表达水平.结果 80例鼻咽癌组织中,E-cadherin低表达48例,高表达32例.随着N分期的进展,E-eadherin的表达水平越低(P=0.018).鼻咽癌颈部转移淋巴结的大小与E-cadherin的表达水平无关(χ2=1.666,P=0.435).颈部转移淋巴结局限于单个区域者的E-cadherin高表达率(69.2%)明显高于分散于多个区域者(25.9%,P=0.000),且在单个区域内单枚淋巴结转移者的E-cadherin高表达率(48.1%)明显高于多枚转移者(25.0%,P=0.044).Ⅱ、Ⅲ、Va区转移者的E-cadherin的高表达率(48.0%)虽高于Ⅰ、Ⅳ、Vb、Ⅵ区转移者(26.7%),但差异并无统计学意义(P=0.059).颈部转移淋巴结与鼻咽癌位于同侧者的E-cadherin高表达率(56.5%)和双侧转移者(32.6%)差异无统计学意义(P=0.059).结论 E-cadherin的表达水平影响鼻咽癌颈部淋巴结转移的区域;E-cadherin的表达水平越低,颈淋巴结转移数目越多,转移距离越远,N分期越晚.E-cadherin的表达水平对鼻咽癌颈部淋巴结自上而下转移的影响较其向对侧淋巴结转移的影响更为显著.     

早期宫颈癌FIGO分期与手术病理分期的差异性及淋巴结转移危险因素的分析

目的 比较宫颈癌临床分期（FIGO分期）与手术病理分期的差异性,探讨影响淋巴结转移的危险因素。方法 收集2010年1月至2014年1月在新疆医科大学第一附属医院经手术治疗的181例早期宫颈癌（FIGO分期ⅠA～ⅡB）患者的临床病理资料进行回顾性分析,比较FIGO分期与手术病理分期的差异,用卡方检验和Logistic回归模型分析影响淋巴结转移的危险因素。结果 ⅠA、ⅠB、ⅡA、ⅡB各临床分期与手术病理分期的符合率分别为57.9％、73.6％、52.1％和39.5％,临床分期总的符合率为59.1％ （107／181）。ⅠA、ⅠB、ⅡA、ⅡB各期的淋巴结转移率分别为10.5％、13.1％、27.1％和50.0％。单因素分析显示鳞状细胞癌抗原（SCCA）、FIGO分期、肿瘤直径、新辅助化疗、肌层浸润深度、脉管内瘤栓及宫旁组织浸润与盆腔淋巴结转移有关（P＜0.05）;多因素分析显示SCCA、FIGO分期、肌层浸润深度及脉管内瘤栓是影响宫颈癌淋巴结转移的独立危险因素,新辅助化疗可减少淋巴结的转移（P＜0.05）。结论 随着FIGO分期的升高,两种分期的符合率呈下降趋势,淋巴结转移率升高。结合临床病理因素,分析影响宫颈癌患者淋巴结转移的相关高危因素,可为制定其合理个体化的治疗方案提供依据。