The Prognostic Clinical Significance Of Perineural Invasion(PNI) In Early Cervical Cancer

Objective:To evaluate the incidence of perineural invasion(PNI),the relationship between other pathological features and PNI and the prognostic clinical significance of PNI in early cervical cancer.Methods:1.We reviewed clinical records of 306 patients with cervical cancer(FIGO IA2-IIA2)after radical hysterectomy in Department of Gynecology,Jiangsu Provincial People's Hospital From January 2008 to December 2015.2.All pathological sections were reviewed by the senior,experienced pathologists,with particular attention to the PNI phenomenon in cervix and uterine tissue.3.A total of 306 patients were followed by telephone,short messages or letters,with an average follow-up of 67.00 months.Results:1.The incidence of PNI in early cervical cancer was 10.5%(32/306).2.The incidence of PNI was correlated with clinical stage,tumor diameter,depth of invasion,lymphovascular spare invasion(LVSI)and lymph node metastasis(P<0.05),but not with age,pathologic type,differentiation degree and preoperative chemotherapy(P>0.05).3.The disease-free survival and overall survival of the PNI-positive group were significantly lower than those of the PNI-negative group.4.Univariate analysis showed that tumor diameter,PNI and clinical stage were correlated with the overall survival time of cervical cancer(P<0.05).The tumor diameter was correlated with disease-free survival time(P = 0.002).5.Multivariate analysis showed that PNI was not identified as an independent risk factor(P = 0.284).Conclusion:1.The PNI is associated with clinical stage,tumor diameter,depth of invasion,LVSI and lymph node metastasis,and affect the prognostic of cervical cancer.2.PNI was a important factor in early cervical cancer,but not an independent risk factor.