宫颈癌患者脉管内癌栓浸润与其他临床病理因素的相关性分析

目的：分析宫颈脉管内癌栓浸润（lymph-vascular space invasion，LVSI）与宫颈癌其他临床病理因素的关系，为指导宫颈癌治疗提供依据。方法：回顾性分析2003年4月—2013年5月上海市第一妇婴保健院收治的462例宫颈癌患者的临床及病理资料，其中LVSI阳性者185例（40%），阴性者277例（60%），对LVSI与肿瘤分期、淋巴结转移及其他临床、病理因素的关系进行相关性分析。结果：单因素分析显示宫颈癌患者LVSI的发生与肿瘤分期、肿瘤大小、浸润深度、淋巴结转移、是否术前经过新辅助治疗有关，而与采用何种新辅助治疗方法无关。LVSI与宫颈癌的其他5项高危因素，即组织病理学类型、间质浸润深度、肿瘤体积、宫旁浸润、淋巴结转移有关；且合并的高危因素越多，LVSI的发生率越高。结论：LVSI与其他病理高危因素密切相关，可能更早地提示淋巴结转移等其他高危因素的潜在风险，对指导宫颈癌的治疗意义重大。

Factors Associated with Lymph-Vascular Space Invasion in Cervical Cancer

Objective:To analyze the relationship between the lymph-vascular space invasion (LVSI) in cervical cancer and other histo-pathologic parameters, in order to provide some guidance for choosing treatment. Methods:Clinical and pathological data of 462 cervical cancer patients were analyzed retrospectively from April 2003 to May 2013 in Shanghai First Maternity and Infant Hospital of which LVSI positive (40%) and 277 cases negative (60%). An analysis was done in terms of the relationship between LVSI and stage and grade of the disease, as well as lymph-node metastasis and other histo-pathologic parameters. Results:In single variable analysis, the presence of LVSI appeared to have obvious relationship with FIGO staging, tumor size, depth of tumor invasion, lymph-nodes metastasis and whether neoadjuvant therapy, but there was no statistic significance with whatever neoadjuvant therapy use. In multivariable analysis, LVSI appeared to have significant association with other histo-pathologic parameters such as histopathological types, stromal invasive depth, tumor size, parametrial infiltration and lymph-nodes metastasis. And the incidence of LVSI was elevated with the increasing number of parameters. Conclusions:LVSI closely related with other pathological risk factors. LVSI can hint the potent danger of lymph-nodes metastasis, and can provide guidance for clinically treatment.