636例早期宫颈癌盆腔淋巴结转移临床分析

摘要

目的 探讨早期宫颈癌患者盆腔淋巴结转移特点.方法 对复旦大学附属妇产科医院2006年6月至2008年5月收治的636例早期宫颈癌患者的手术治疗资料进行回顾性分析,探讨早期宫颈癌患者盆腔淋巴结转移特点.患者年龄28～67岁,中位年龄(45.6±3.8)岁.结果 病理类型分为鳞癌、腺癌两大类,其中鳞癌587例(92.3%)、腺癌49例(7.7%).636例患者进行了盆腔淋巴结清扫术,各期总的转移率为10.9%(69/636),其中鳞癌61例、腺癌8例,二者的盆腔淋巴结转移率差异无统计学意义(P＞0.05).Ⅰb2期后淋巴结转移率明显上升(P＜0.05),闭孔淋巴结的阳性率明显高于其他各组淋巴结(P＜0.05).结论 宫颈癌患者Ⅰb1期起,盆腔淋巴结的转移率明显上升,并以闭孔淋巴结转移为主(69/120),常规盆腔淋巴结清扫十分重要.%Objective To evaluate the clinical characteristics of pelvic lymph node metastases in patients with early-stage cervical carcinoma. Methods The clinical, pathologic and follow-up data of patients with cervical carcinoma treated at our hospital from June 2006 to May 2008 were collected and analyzed retrospectively. The relevant literature was reviewed. Results The median age at diagnosis was (45.6 +3. 8) years old. Among these patients, 587 patients ( 92. 3% ) were of squamous cell cervical carcinoma while 49 patients ( 7. 7% ) cervical adenocarcinoma. But the differences of pelvic lymph node metastases were not significant ( P ＞ 0. 05 ). The overall prevalence of lymph node metastasis was 10. 9%(69/636). The rate of pelvic lymph node metastases became significantly high up from the clinical stage Ⅰb1.When the pelvic nodes were positive,the obturator group was involved in 69 cases (69/120). Conclusion There is an increased rate of pelvic lymph node metastasis in the patient groups of clinical stage Ⅰb1- Ⅱ. And the obturator group is predominantly involved. Thus a routine pelvic lymphadenectomy is essential.