早期宫颈癌保留生育功能核心指标的临床研究

发布时间：2019-06-29 11:29

【摘要】：目的本研究探讨了早期宫颈癌患者保留生育功能的影响因素及其可行性。 方法本研究选取了133例宫颈癌FIGO分期为I期的患者，回顾性分析其肿瘤浸润深度比例，肿瘤病灶大小以及肿瘤病理类型，深入探讨其对于宫旁浸润，脉管累及，淋巴转移的影响。 结果①26例Ia1期患者，无脉管累及；其中2例行盆腔淋巴结清扫术，无淋巴转移。②7例Ia2期患者，均无宫旁浸润、脉管累及和淋巴转移。③88例Ib1期患者，宫旁浸润10例（11.4%）、脉管累及19例（21.6%）、淋巴转移11例（12.5%）。④12例Ib2期患者，宫旁浸润1例（8.3%）、脉管累及2例（16.7%）、淋巴转移1例（8.3%）。⑤当肿瘤浸润深度比例≥1/2时，更容易发生转移。⑥当肿瘤浸润深度比例≥2/3时，更容易发生宫旁浸润及淋巴转移。⑦肿瘤浸润深度比例与脉管累及无关，肿瘤的病灶大小与有无转移无关。 结论宫颈癌Ia1期患者，若无脉管累及，可行宫颈锥形切除术；若有脉管累及，需行广泛子宫颈切除术，保留生育功能。宫颈癌Ia2期患者，若无脉管累及，可以选择广泛子宫颈切除术。宫颈癌Ib1期患者，若无脉管累及，肿瘤最大直径≤2cm，肿瘤浸润深度比例小于1/2，无淋巴转移，可行广泛子宫颈切除术，，保留生育功能，但术后需注意密切随访。
[Abstract]:Objective to investigate the influencing factors and feasibility of fertility retention in patients with early cervical cancer. Methods in this study, 133 patients with stage I cervical cancer with FIGO stage were analyzed retrospectively. the proportion of tumor invasion depth, the size of tumor focus and the pathological type of tumor were analyzed retrospectively. the effects of tumor invasion, vascular involvement and lymph node metastasis on periuterine invasion, vascular involvement and lymph node metastasis were discussed in detail. Results there were no vascular involvement in 126 patients with Ia1. Pelvic lymph node dissection was performed in 2 cases, no lymph node metastasis. 27 patients with Ia2 stage had no paracymal invasion, vessel involvement and lymphatic metastasis. 388 patients with Ib1 stage, 10 patients with periuterine infiltration, 19 patients with periuterine invasion, 11 patients with lymph node metastasis, 412 patients with Ib2 stage, 1 patient with periuterine invasion, 2 patients with periuterine invasion, 12. 5% patients with Ib2 stage, 1 patient with periuterine infiltration, 2 patients with periuterine invasion, 11 patients with lymph node metastasis, 11 patients with paracircular lymph node involvement, 11 patients with paracymal lymph node metastasis. Lymph node metastasis occurred in 1 case (8.3%). 5 when the ratio of tumor invasion depth 鈮

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