摘要
目的 探讨局部晚期宫颈癌(LACC)淋巴结转移发生的高危因素及其对预后的影响.方法 回顾性分析97例Ⅰ B2～ⅣA期LACC病人的临床资料,其中发生淋巴结转移55例.应用Logistics回归分析淋巴结转移的高危因素,采用Kaplan-Meier曲线和Log-rank检验分析淋巴结转移及其高危因素对无进展生存期(PFS)的影响.结果 单因素分析表明,淋巴结转移阳性组和阴性组年龄、FIGO分期、鳞状细胞癌抗原(SCC)水平、糖类抗原125(CA125)、白细胞计数、血红蛋白、中性粒细胞计数、肿瘤大小以及间质浸润深度差异均有统计学意义(t=-3.157～2.173,U=12.314～1 569.000,P＜0.05).多因素分析显示,FIGO 分期(OR=3.204,95％CI=2.423～6.153,P=0.004)、SCC 水平(OR=1.050,95％CI=1.009～1.092,P=0.017)、肿瘤大小(OR=1.045,95％CI=1.015～1.076,P=0.003)是淋巴结转移的独立危险因素.生存分析显示,淋巴结转移是PFS的影响因素(HR=3.944,95％CI=1.744～8.920,P=0.001);FIGO 分期(HR=2.749,95％CI=1.216～6.215,P=0.015)、SCC 水平(HR=20.552,95％CI=6.419～65.796,P＜0.001)、肿瘤大小(HR=9.384,95％CI=2.614～33.687,P＜0.001)对LACC的PFS具有很好的风险分层价值.结论 FIGO分期、SCC水平和肿瘤大小是LACC淋巴结转移的独立危险因素.
Abstract
Objective To investigate the high-risk factors for lymph node metastasis in locally advanced cervical cancer(LACC)and their impact on prognosis.Methods A retrospective analysis was performed for the clinical data of 97 patients with stage I B2-ⅣA LACC,among whom 55 patients experienced lymph node metastasis.A Logistic regression analysis was used to investigate the high-risk factors for lymph node metastasis,and the Kaplan-Meier curve and the Log-rank test were used to investi-gate the impact of lymph node metastasis and its high-risk factors on progression-free survival(PFS).Results The univariate a-nalysis showed that there were significant differences between the positive lymph node metastasis group and the negative group in age,International Federation of Gynecology and Obstetrics(FIGO)stage,squamous cell carcinoma antigen(SCCA),carbohy-drate antigen 125,white blood cell count,hemoglobin,neutrophil count,tumor size,and depth of stromal invasion(t=-3.157 to 2.173,U=12.314-1 569.000,P＜0.05).The multivariate analysis showed that FIGO stage(OR=3.204,95％CI=2.423-6.153,P=0.004),SCCA level(OR=1.050,95％CI=1.009-1.092,P=0.017),and tumor size(OR=1.045,95％CI=1.015-1.076,P=0.003)were independent risk factors for lymph node metastasis.The survival analysis showed that lymph node metastasis(HR=3.944,95％CI=1.744-8.920,P=0.001)was an influencing factor for PFS,and in addition,FIGO stage(HR=2.749,95％CI=1.216-6.215,P=0.015),SCCA level(HR=20.552,95％CI=6.419-65.796,P＜0.001),and tumor size(HR=9.384,95％CI=2.614-33.687,P＜0.001)had a good risk stratification value for PFS in LACC.Conclusion FIGO stage,SCCA level,and tumor size are independent risk factors for lymph node metastasis in LACC.
基金项目
中国博士后科学基金资助项目(2019M662307)
国家科技期刊平台
NSTL
万方数据