Research Of Clinic-pathological Features In Microscopic Ⅰb1 Stage Squamous Cervical Cancer And Relationship Between FABP7、NCAM And Perinueral Invasion

Objective:(1)To describe and compare the clinic-pathological features and prognostic factors between microscopic and clinical-visible Ib1 SCC.(2)To compare the clinical-pathological characteristics between patient of Ib1 SCC with or without perineural invasion.(3)To elaborate the clinical significance of FABP7 and NCAM in patient of Ib1 SCC with or without perineural invasion.Method:(1)Clinical-pathological data of patients with Ib1 SCC who underwent RH in our hospital from April 1,2011 to August 31,2015 were analyzed retrospectively,who were divided into microscopic and clinical-visibale group in which clinical-pathological features and prognosis compared.(2)The clinical-pathological features of patients with or without PNI in Ib1 SCC were retrospectively analyzed.(3)Expression of FABP7 and NCAM in patients with or without PNI in Ib1 SCC were examinated by immunohistochemistry.Results:(1)There were 49 patients with microscopic Ib1 SCC,whose records were intact,median follow-up 33±15.0monthes.the rate of I,II,III type of TZ was 71%,6%,23% respectively.The rate of satisfactory and unsatisfactory colposcopy was 78%,22% respectively.According to cervical biopsy,the rate of HSIL and suspective microscopic invasive cancer was 55%,45% respectively.According to type of invasive stromal,the rate of multifocal and “tongue-like” invasion was 55%,45%respectively.There was only 1 patient with parametrial and vaginal involvement respectively,1 patient with recurrence and death.(2)There were 149 patients with clinical-invisible Ib1 SCC,whose records were intact.Compared to 49 patients microscopic Ib1 SCC,There was no significant difference of mean age and follow-up time between these two groups.There were significant differences of Scc-Ag,histology,LVSI,depth of invasive stromal,PLN metatasis,post-operative adjuvant therapy between these two groups.There was no significant difference of post-operative margin involvement,PI,recurrence and survival rate between these two groups.Outcomes were not influenced by LVSI,depth of invasive stromal,PI and margin involvement with univariate analysis.PLNmetatasis was accosiated with LVSI、tumor size and depth of invasive stromal by univariate analysis.There was accosiation between depth of invasive stromal and PLN metatasis by multivariate analysis.(3)56 Ib1 SCC patients with diameter >2cm were screened with microscopy by experienced pathologist for PNI status.There were 26 patients and 30 patients in PNI(+)and PNI(-)group respectively.There was no significant difference of mean age and follow-up time between two groups.There was no significant difference of Scc,depth of invasive stromal,LVSI,histology,PI,margin involvement,recurrence and survival rate between two groups.There was significant difference of PLN metastasis between two groups.The rate of FABP7(+)tumor cell was 20%(11/56).There was significant difference of rate of FABP7(+)tumor cell between two groups.4 patients with FABP7(+)SCs in PNI(+)group and 1patient in PNI(-)group.There was no significant difference between two groups.There was no patient with lymph cell positive in tumor or para-tumor tissue.(6)The rate of positive tumor cell of NCAM was 7%(4/56).No patient with positive NCAM tumor cell found in PNI(+)group.4 patients in PNI(-)group.There was no significant difference between two groups.No positive nevers found in two groups.1 patients with positive NCAM lymph cell in tumor tissue in two groups respectively.1 patient and 6 patients with positive NCAM lymph cell in para-tumor tissue in PNI(+)and PNI(-)group.There was no significant difference between two groups.Conclusion:(1)Good outcomes is better in microscopic Ib1 stage SCC with high rate of LVSI and low rate of PLN metatasis,margin involvement,parametrial involvement post-operative adjuvanet therapy.HRFs of microscopic Ib1 stage SCC was lower than the other group.(2)PLN metatasis was accosiated with LVSI、depth of invasive stromal and tumor size.The accosiation between PLN metastasis and depth of stormal was very close.(3)PNI was associated with pelvic lymph node metastasis.(4)PNI was accosiated with increased expression of FABP7 in tumor cell.NCAM was rarely expressed in SCC.