Perineural Invasion In The Significance Of Early Cervical Cancer

Objective: Cervical cancer is one of the malignant tumor which is a serious threat to the health of women. Its incidence of a disease is located in the second place, and morbidity and mortality increased year by year and gradually younger. The treatment of cervical cancer is determined by the clinical staging, locally advanced cervical cancer is mainly with radiation therapy and chemotherapy drugs. For patients with early cervical cancer, mainly adopts surgery to resect lesions at present, then according to the known clinical risk factors for whether for radiotherapy or chemotherapy. Known clinical risk factors are surgical cut edge, lymph nodes, distant metastasis, infiltration depth is more than 1/2, tumors larger than 4 cm, etc. These known risk factors are important indicators to guide clinical work.Perineural invasion(Perineural invasion,PNI) refers to the tumor cell infringe nerve tissue and growing and violating along with it. It is considered as one of the route of metastasis in addition to lymphatic metastasis, blood route metastasis, mplantation metastasis and direct spreading. In recent years in research of pancreatic cancer, colon cancer, gallbladder carcinoma, gastric cancer, colorectal cancer and other malignant tumors, were found that perineural invasion is a unique histological, it is also an important pathological factor of poor prognosis.At present, the studies of PNI and cervical cancer is less, whether it affects the prognosis is unknown. The study is to explore the relationship between PNI and the prognosis of early cervical cancer as well as the correlation with other clinical risk factors, and providing a new method for clinical treatment of early cervical cancer.Methods: Collect 85 patients with early-stage cervical cancer(stagesⅠA2-ⅡA) who underwent radical hysterectomy with pelvic lymph node dissection during March, 2009- March, 2014. Read again the pathological section and mark cervical tissue nerve by immunohistochemical staining. Than Observe neural invasion situation, and make a statistical analysis to screen risk factors related to prognosis. Result:There are 10 patients(11.8%) with PNI-positive in total 85 patients. PNI has correlation with lymph node positive matter,organ metastasis,positive surgical margins and vessel invasion(P<0.05), and it has no correlation between clinical stage, differentiation, pathological type, tumor size and tumor infiltration depth(P>0.05). With the extension of time, the survival rate of PNI-positive patients is significantly lower than the PNI-negative ones, differences are statistically significant. Positive lymph nodes, and vascular infiltration are independent risk factors related to prognosis of cervical cancer by Cox Multiple factors analysis, but the PNI is not directly related to the prognosis. Conclusion: PNI may think as another way of cervical cancer metastasis, and it can be used as a risk factor of postoperative recurrence, guiding early cervical cancer adjuvant radiation and chemotherapy after surgery. To Keeping nerve cervical cancer radical prostatectomy, strictly master the operation indications is the way to reduce the recurrence rate.