Early Cervical Cancer Para-aortic Lymph Nodes Biopsy Clinicopathological Analysis Of137Cases

Objective By analyzing the relationship between the risk of para-aortic lymphnode metastasis, and clinical pathological factors in patients with early cervical cancerto explore the risk factors of early cervical cancer para-aortic lymph nodemetastasis.Provide the basis for clinical early cervical cancer individualized para-aorticlymph node dissection.Materials and Methods To collect the137patients of Ia2~IIa2of early cervicalcancer patients undergoing abdominal aortic lymph node sampling technique inLiaoning Provincial Tumor Hospital from November2008to March2012clinical andpathological data,include age, clinical stage, gross type, tumor size, tumordifferentiation, histological type, depth of invasion, vaginal margin, vascularinvasion, preoperative radiotherapy to shrink the tumor, pelvic lymph nodes (Internaliliac, external iliac, obturator) common iliac lymph nodes, and the number ofPara-aortic lymph node dissection and transfer.Summary of cervical cancer peritoneallymph node metastasis rate, retrospective analysis of clinicopathological factors aboutpara-aortic lymph node metastasis: statistical software SPSS16.0Pearsonχ2test, exacttest (Fisher Exact Test) and multivariate logistic stepwise regression was used forstatistical analysis.Results1.137cases of early cervical cancer patients undergoing Radical or Timesradical hysterectomy, pelvic lymphadenectomy and para-aortic lymph node samplingtechnique, a total of41cases occurred retroperitoneal lymph node metastasis,metastasis rate of29.93%. Pelvic lymph nodes (including the obturator, internal iliac,external iliac) transferred39cases, the transfer rate of28.47%, followed by thecommon iliac lymph node metastasis in12cases, the transfer rate of8.76%, theabdominal aorta lymph node metastasis in9cases, the transfer rate of6.57%. Commoniliac, abdominal skip metastasis in1case, metastasis rates were0.73%. 2.In accordance with staging cervical cancer2009FIGO, Ia2of four cases, thetransfer rate of0; Ib1to Ib296cases, retroperitoneal lymph node metastasis rate of27.08%, including pelvic lymph node metastasis rate of25%,6.25%of the commoniliac lymph node metastasis rate, abdominal para-aortic lymph node metastasis rate4.17%; IIA1to IIA2of37cases of retroperitoneal lymph node metastasis rate of40.54%, pelvic lymph node metastasis rate of40.54%,16.22%of the common iliaclymph node metastasis rate, para-aortic lymph node metastasis rate of13.51%.Visible,with the increase of the clinical stage,the cervical cancer lymph node metastasis rateincreased. Statistical analysis showed no significant difference of the two groups ofstaging lymph node metastasis rate.3.Early cervical cancer retroperitoneal lymph node most likely to transfer parts ofthe pelvic lymph nodes (order of the obturator internal iliac lymph nodes-external iliaclymph nodes), followed by the common iliac lymph nodes, para-aortic lymph nodemetastasis at least. The number of pelvic lymph node metastasis in cervical cancer≥3or common iliac lymph node metastasis≥1and para-aortic lymph node metastasis wassignificantly associated.4.137early cervical cancer patients the single factor analysis betweens PALNmetastasis and clinicopathological factors: cervical cancer pathological type andpara-aortic lymph node metastasis was statistically significant (x2=6.517, P=0.030);cervix cancer lesions>4cm (OR=4.464; P=0.037), poor differentiation (OR=5.600;P=0.026), vaginal margin-positive (OR=18.000; P=0.022), vascular invasion-positive (OR=6.369; P=0.013), the invasion run deep muscle (OR=5.460; P=0.034). Pelvic lymph node metastasis (OR=25.032; P=0.000) and common iliaclymph node metastasis (OR=25.417;P=0.000) and para-aortic lymph nodemetastasis was significantly Relevance (P <0.01).5.Multivariate logistic regression analysis showed: histological type, vaginalresection margin, the number of common iliac lymph node metastasis≥1exp (B)11.828;100.643;405.907, more than1, so that these three factors are early cervicalcancer para-aortic lymph node metastasis were independent risk factors, pathologicaltype adenosquamous carcinoma or other rare non-squamous cell carcinomahistological type, vaginal margin positive, the number of common iliac lymph nodemetastasis≥1early cervical cancer patients with abdominal the possibility ofpara-aortic lymph node metastasis. ConclusionCervical cancer patients with retroperitoneal lymph node metastasis with a certainregularity.The most vulnerable to the transfer of parts of the pelvic lymph nodes: orderobturator internal iliac lymph nodes, external iliac lymph nodes, followed by thecommon iliac lymph nodes, para-aortic lymph node metastasis at least. Retroperitoneallymph node metastasis rate gradually increased with the increase of cervical cancerpatients with clinical stage.In addition, patients with early cervical cancer tumordiameter>4cm, pathological type of adenosquamous carcinoma or other rarenon-squamous cell histology type, degree of differentiation poor, vaginal positivemargins, presence of vascular invasion, invasion Run deep myometrial,pelvic lymphnode and/or common iliac lymph node metastasis positive, para-aortic lymph nodemetastasis. Early pathological types of cervical cancer adenosquamous carcinoma orother rare non-squamous cell histology type, vaginal margin positive, the number ofcommon iliac lymph node metastasis≥1is an independent risk factor for para-aorticlymph node metastasis, the clinical emergence of these high-risk factors should beactively line para-aortic lymph node dissection.