Pelvic Lymph Node Metastasis Risks In Cervical Cancer

Objective: To find some risk factors for the lymph node metastasis in early-stage cervical cancers.Method: A retrospective study was performed, which consisted of cervical cancer patients who underwent radical hysterectomy with pelvic lymphadenectomy in the Second Affiliated Hospital of Chongqing Medical University from February 2008 tod October 2014. We extracted some clinic varieties and molecular indexes to analyze the relationships with lymph node metastasis of cervical cancer.Result: Thirty-five patients were diagnosed with pelvic lymph node metastasis(PLNM), and the incidences of PLNM in patients with FIGO stage IB, stage IIA were 11.0%(16/146) and 34.5%(19/55), respectively. Patients with superficial-middle and deep stromal invasion, the incidences were 4.7%(5/107) and 31.9%(30/94), respectively. Univariate analysis showed that FIGO stage, depth of stromal invasion, parameterium involvement and lymphovascular involvement were associated with PLNM(p<0.05). Multivariate analysis showed that FIGO stage(Odds Ratio 2.887; 95% CI 1.245-6.698; p=0.014), depth of stromal invasion(Odds Ratio 5.961; 95% CI 2.105-16.874; p=0.001) and lymphovascular space invasion(Odds Ratio 2.476; 95% CI 1.076-5.696; p=0.033) were significantly and independently associated with PLNM. Futhermore, patients with positive Cerb B-2 had a 215% higher chance of lymph node metastasis compared with negative Cerb B-2 patients(OR=3.158, 95% CI 1.414-7.053, p=0.004), and patients with p53 positive had a 319% higher chance of lymph node metastasis compared with p53 negative patients(OR=4.916, 95% CI 1.409-17.155, p=0.007).Conclusion: FIGO stage, depth of stromal invasion(DSI) and lymphovascular space invasion(LVSI) are all high risk factors for pelvic lymph node metastasis in cervical cancer. Expression of Cerb B-2 and p53 are closely associated with PLNM of cervical cancer.