宫颈癌周围神经侵犯与复发高危因素的关联研究

王黎黎; 张映红; 杜文杰; 朱桃花

doi:10.19401/j.cnki.1007-3639.2019.06.007

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宫颈癌周围神经侵犯与复发高危因素的关联研究

论著 | 更新时间：2026-01-27

- 宫颈癌周围神经侵犯与复发高危因素的关联研究
- Association between peripheral nerve invasion and recurrence risk factors in cervical cancer
- 中国癌症杂志 2019年29卷第6期页码：439-444
- 作者机构：
  
  铜陵市妇幼保健院妇科,安徽,铜陵,244000
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2019.06.007
  中图分类号： R737.33
- 网络出版：2019-07-12，
  
  纸质出版：2019-07-12
- 稿件说明：
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刘山，房娟，王黎黎，张映红，杜文杰，朱桃花. 宫颈癌周围神经侵犯与复发高危因素的关联研究[J]. 中国癌症杂志, 2019, 29(6): 439-444.

王黎黎, 张映红, 杜文杰, et al. Association between peripheral nerve invasion and recurrence risk factors in cervical cancer[J]. China Oncology, 2019, 29(6): 439-444.
刘山，房娟，王黎黎，张映红，杜文杰，朱桃花. 宫颈癌周围神经侵犯与复发高危因素的关联研究[J]. 中国癌症杂志, 2019, 29(6): 439-444. DOI： 10.19401/j.cnki.1007-3639.2019.06.007.

王黎黎, 张映红, 杜文杰, et al. Association between peripheral nerve invasion and recurrence risk factors in cervical cancer[J]. China Oncology, 2019, 29(6): 439-444. DOI： 10.19401/j.cnki.1007-3639.2019.06.007.

摘要

背景与目的：宫颈癌是临床常见的妇科恶性肿瘤。分析宫颈癌周围神经侵犯（peripheral nerve invasion，PNI）与复发高危因素之间的关联性。方法：收集安徽省铜陵市妇幼保健院2010年3月—2018年3月按照国际妇产科联盟（International Federation of Gynecology and Obstetrics，FIGO）分期为ⅠA2~ⅡA期宫颈癌手术的65例患者的全部临床资料，研究宫颈癌周围神经侵犯与其他临床病理特征的关系以及其对宫颈癌患者预后的影响，并分析宫颈癌周围神经侵犯与复发高危因素的关联。结果：神经侵犯阳性与淋巴结阳性、手术切缘阳性以及脉管侵犯具有相关性，且差异有统计学意义（P0.05）。神经侵犯阳性与临床分期、分化程度、病理学类型、肿瘤大小、肿瘤浸润深度无相关性，且差异无统计学意义（P0.05）。通过随访发现，神经侵犯阳性患者的5年无复发生存率明显低于阴性的患者（P＜0.05）。神经侵犯阳性组与阴性组的5年生存率差异无统计学意义（P＞0.05）。全部的Cox多因素分析结果表明，癌细胞分化程度低、深肌层癌细胞浸润以及盆腔淋巴结转移属于影响复发的主要危险因素（P0.05），神经侵犯不属于影响宫颈癌术后患者生存的独立预后因素（P＞0.05）。结论：宫颈癌周围神经侵犯能够明显降低患者的5年无复发生存率，属于宫颈癌发生转移的其中一种途径，能够作为术后的复发高危因素，对早期宫颈癌术后辅助放化疗有指导意义。

Abstract

Background and purpose: Cervical cancer is a common type of gynecological malignant tumor. This study aimed to analyze the association between peripheral nerve invasion (PNI) and recurrence risk factors in cervical cancer. Methods: This study collected the clinical data of 65 patients with ⅠA2-ⅡA cervical cancer who underwent operation in Tongling Maternal and Children Health Care Hospital from Mar. 2010 to Mar. 2018

in accordance with the International Federation of Gynecology and Obstetrics (FIGO) stage. The relationship between the PNI of cervical cancer and other clinicopathological features and the significance of the prognosis of cervical cancer were studied

and the correlation of the risk factors for invasion and the recurrence of cervical cancer was analyzed. Results: The results showed that PNI positivity was correlated with lymph node positivity

surgical margin positivity and vascular invasion positivity (P0.05). However

there was no correlation between the PNI positivity and the clinical stage

the degree of differentiation

the pathological type

the size of the tumor and the depth of tumor invasion (P0.05). The follow-up results showed that the 5-year recurrence-free survival rate of the PNI positive group was significantly lower than that of the negative group (P0.05). There was no significant difference in the 5-year survival rate between the PNI positive group and the negative group (P0.05). The results of all COX multivariate analyses showed that low degree of differentiation

infiltration of deep myometrium and metastasis of pelvic lymph nodes were main risk factors (P0.05)

which were not independent prognostic factors for the survival of patients after cervical cancer operation (P0.05). Conclusion: Cervical cancer nerve invasion can significantly reduce patient’s 5-year recurrence-free survival rate

which belongs to one of the pathways of cervical cancer metastasis. It can be used as a high-risk factor for postoperative recurrence

which can guide adjuvant chemotherapy for early-stage cervical cancer.

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