江苏省妇幼健康科研项目（F201438）
目的：探讨早期子宫颈癌嗜神经侵袭(perineural invasion，PNI)对预后的意义。方法：回顾分析自2008年1月—2015年12月在南京医科大学第一附属医院妇科接受根治性子宫颈癌手术的306例早期(ⅠA2~ⅡA2期)子宫颈癌患者的临床及随诊资料。结果：①早期子宫颈癌中PNI的发生率为10.5%(32/306)；②PNI与肿瘤直径、浸润深度、淋巴脉管间隙浸润和淋巴结转移均相关(P＜0.05)；③PNI阳性组的无瘤生存率及总生存率明显低于PNI阴性组；④单因素分析显示肿瘤直径、PNI及临床分期与子宫颈癌总生存时间有关(P＜0.05)，肿瘤直径与无瘤生存时间有关(P=0.002)；⑤多因素分析显示PNI并非是影响子宫颈癌总生存时间的独立危险因素(P=0.154)。结论：PNI与肿瘤直径、浸润深度、淋巴脉管间隙浸润和淋巴结转移均具有相关性，PNI影响子宫颈癌患者的预后，但并非独立危险因素。
Objective：To evaluate the prognostic significance of perineural invasion (PNI) in patients with early cervical cancer. Methods：We reviewed clinical records and pathology slides of 306 patients with cervical cancer(FIGO IA2IIA2) after radical hysterectomy in Department of Gynecology，Jiangsu Provincial People′s Hospital From January 2008 to December 2015. Results：①The incidence of PNI in patients with early cervical cancer was 10. 5%(32/306). ②The incidence of PNI was correlated with tumor diameter，depth of invasion，lymphovascular spare invasion (LVSI) and lymph node metastasis(P＜0.05). ③The disease-free survival and overall survival of the PNI-positive group were significantly lower than those of the PNI-negative group. ④Univariate analysis showed that tumor diameter，PNI and clinical stage were correlated with the overall survival time of cervical cancer(P＜0.05). The tumor diameter was correlated with disease-free survival time (P=0.002). ⑤Multivariate analysis showed that PNI was not identified as an independent risk factor(P=0.154). Conclusion：The PNI is associated with tumor diameter，depth of invasion，LVSI and lymph node metastasis，and affect the prognostic of cervical cancer，but is not an independent risk factor.
顾嘉敏,袁 琳,程文俊,韩素萍,尤志学,傅士龙.嗜神经侵袭对早期子宫颈癌预后的临床意义[J].南京医科大学学报（自然科学版）,2017,(5):615-619
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