嗜神经侵袭对早期子宫颈癌预后的临床意义
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江苏省妇幼健康科研项目(F201438)


Clinical prognosis significance of perineural invasion in early-stage cervical cancer
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    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。

    Abstract:

    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.

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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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  • 收稿日期:2017-01-17
  • 在线发布日期: 2017-06-01
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