神经侵犯与宫颈癌临床病理特征的关系及预后分析

摘要

目的:探讨神经侵犯(perineural invasion,PNI)与宫颈癌临床病理特征及术后辅助治疗的关系,并分析其对宫颈癌生存率的影响.方法:回顾性分析506例在中国医科大学附属盛京医院进行广泛性全子宫切除术+盆腔淋巴结清扫术±腹主动脉旁淋巴结清扫术的宫颈癌患者的临床病理特征,分析宫颈癌PNI与宫颈癌临床病理特征及术后接受辅助治疗的关系,并分析其对宫颈癌术后复发及死亡结局的影响.结果:506例宫颈癌患者中PNI阳性48例,发生率为9.5%(48/506),PNI发生率在淋巴结转移、切缘累及、宫颈间质浸润深度、淋巴血管间隙浸润方面的差异有统计学意义(P<0.05),PNI阳性患者术后需接受辅助治疗比例明显多于PNI阴性患者,差异有统计学意义(P<0.05).单因素分析提示,宫颈癌无复发生存率与PNI相关(P<0.05).多因素分析提示,宫颈癌PNI为宫颈癌复发的独立危险因素.结论:PNI是判断宫颈癌复发的独立指标,可以为宫颈癌术后是否需要进一步辅助治疗提供指导.%Objective:To investigate the relationship between perineural invasion(PNI)and clinical pathological features of cervical cancer and adjuvant therapy after operation and the effect on the survival rate of cervical cancer. Methods:The clinical and pathological features of 506 patients with cervical carcinoma who underwent total hysterec-tomy and pelvic lymph node dissection at the Shengjing Hospital of China Medical University were retrospectively ana-lyzed.To analyze the relationship between PNI of cervical cancer and the clinical and pathological features of cervical cancer and the effect of adjuvant therapy and the effect of cervical cancer recurrence and mortality.Results:In 506 cases of cervical cancer patients with positive PNI,the incidence was 9.5%(48/506).The incidence of PNI was sig-nificantly different in the lymph node metastasis,the incisal margin involvement,the infiltration depth of the cervical stroma,and the infiltration of the lymphatic vessel space(P<0.05).The proportion of positive PNI patients receiving adjuvant therapy was significantly higher than that of negative PNI patients and the difference was statistically signifi-cant(P<0.05).Single analysis showed that the recurrence free survival rate of cervical cancer was correlated with positive PNI(P<0.05).Multivariate analysis showed that PNI was an independent risk factor for cervical cancer re-currence.Conclusion:Positive PNI is an independent index to judge the recurrence of cervical cancer,which can pro-vide guidance for the further treatment of cervical cancer.