Application Of PTNM Staging In Early Cervical Cancer

Background and ObjectiveAt present,cervical cancer in the womb is a nightmare for all women because it is the most common malignant neoplasm in all women's reproductive system diseases.Its occurrence will seriously threaten women's life and health.Even though the development of cancer screening by women through physical examination in recent decades has greatly reduced the mortality rate of cervical cancer in the uterus,how can we improve the clinical diagnosis and treatment of cervical cancer in the uterus?This problem still needs to be further explored and resolved.Precise staging is an important factor in influencing how to choose a reasonable and effective treatment plan and how to perform an expected postoperative evaluation of cervical cancer in the uterus.Uterine cervical cancer as the most common female malignant tumor is the only clinical stage.The current clinical staging criteria for cervical cancer in the uterus is still established by the International Federation of Gynecology and Obstetrics(FIGO).This stage,which has long been recognized as a criterion for clinical diagnostic classification of cervical cancer in the cervix,is considered to be a uniform standard because it is highly practical.However,due to various uncertainties such as differences in the clinical diagnosis among different physicians,the limitations of clinical examination methods in various localities,and the fact that auxiliary examinations such as imaging examinations have not yet been popularized,they lead to a higher proportion of clinical symptom staging.Postoperative pathological findings produce inconsistent results.Therefore,the development of a cervical cancer diagnosis and treatment plan and the effect of cervical cancer diagnosis and treatment are subject to subtle changes due to inaccurate clinical stages,and it is not easy to fully and accurately determine many important factors in the recovery of cervical cancer after surgery.In summary,some researchers have proposed that patients with cervical cancer can be surgically staged to resolve the above problems.In recent years,with the constant improvement and development of the TNM staging developed by the Union for International Cancer Control(UICC),FIGO has used the Pathological TNM classification as the pathological stage of uterine cervix cancer,and the appearance of pTNM staging is How to find an effective postoperative auxiliary treatment method and how to accurately assess the postoperative recovery provides a strong basis.This study focuses on the comparison between the FIGO stage and the pTNM stage in the early stage of uterine cervix cancer.It also discusses the problems of the FIGO stage.Finally,it also studies the importance and feasibility of pTNM staging.Materials and methodsAfter analysis of clinicopathological data of 315 early cervical cancer patients in the Second Affiliated Hospital of Zhengzhou University,these patients belonged to stage IA~IIB in FIGO,and the clinicopathological materials of these patients with cervical cancer were all from 2004.The data materials obtained after the surgery was performed from January 1st to June 1st,2012,and confirmed by pathological examination.Comparing the coincidence rate of pTNM staging and FIGO staging,some results can be obtained by calculation:preoperative clinical examination of the patient's vaginal aggression sensitivity,accuracy,specificity,positive predictive value and negative predictive value,and clinical The sensitivity,accuracy,specificity,positive predictive value,and negative predictive value of the judgement of the parauterine intrusion judgments were calculated by medical examination,and the FIGO staging lymph node metastasis rate was calculated.Finally,the statistics of the FIGO staging and pTNM staging were calculated and the ratio of surviving after 5years(disease-free survival DFS)and 5-year total survival ratio(OS)were calculated.The collected data materials were calculated by applying SPSS 23.0 statistical software.All the calculated digital materials were calculated using the chi-square test(?~2).In addition,Kaplan-Meier survival analysis was used for survival.P<0.05 was considered statistically significant.Results1.The total compliance rate of FIGO staging and pTNM staging is 64.4%.The match rates for IA,IB,IIA,and IIB were 76.0%,74.9%,50.7%,and 41.3%,respectively.2.The predictive value and negative predictive value of the sensitivity,specificity,positive and negative of vaginal invasion determined by clinical medical examination are:44.2%,75.7%,26.4%,87.3%,and the accuracy is 70.5%..The difference in vaginal invasion during different sub-periods was statistically significant(P<0.01).3.The sensitivity,specificity,positive predictive value,and negative predictive value of paracervical invasion determined by clinical medicine examination were:55.9%,90.4%,41.3%,94.4%,and the accuracy was 86.7.%.The result of the difference in the period of peri-uterine invasion during different points was statistically significant(P<0.01).4.The total positive rate of the calculated lymph nodes was 22.5%(71/315).The ratio of metastatic lymph nodes in different stages of the International Federation of Obstetrics and Gynecology was 8.0%(2/25)in IA and 14.0%in IB.(24/171),28.8%(21/73)in IIA,and 52.2%(24/46)in II B.The difference in lymph node metastasis during different FIGO points was statistically significant(P<0.01).5.FIGO staging 5-year survival rate:IA phase 100%,IB phase 91.8%,IIA phase87.7%,IIB phase 69.1%;5-year disease-free survival rate:IA phase 92.0%,IB phase88.9%,IIA phase 74.0%,IIB period 43.2%.The five-year survival rate of pTNM was100%in CINIII,97.7%in IA,93.2%in IB,81.7%in IIA,81.6%in IIB,and 42.9%in IIIA;5-year disease-free survival rate was 100%in CINIII and 90.7%in IA.91.8%of the IB period,72.8%of the IIA period,29.2%of the IIB period,and 28.6%of the IIIA period.The difference in the survival rate curves during the different sub-periods was statistically significant(P<0.05).Conclusions1.There is a significant difference between the FIGO stage and the pTNM stage.The matching rates of the four periods IA,IB,IIA,and IIB have one thing in common.That is,these four stages will gradually decline along with the gradual increase of the stage,showing an inverse ratio.Relationship.The highest error rate in the four periods of IA,IB,IIA,and IIB is the error rate in stage IIB.If the final stage of the stage is higher,the patient who could have performed the surgery will lose the opportunity for optimal surgical treatment.2.The clinical medical examination has a considerable proportion of errors and deviations in the judgment of vaginal infiltration,parametrial infiltration,and postoperative pathological findings,which in turn affects the accuracy of FIGO staging.3.The metastasis or proliferation of lymph nodes is a relatively key element in evaluating the prognosis of cervical cancer in the uterus.The pathological staging of pTNM determines the distant spread of lymph nodes and metastasis to other systems.Compared with the clinical stage of FIGO,pTNM pathological stage It can more accurately reflect the extent of the lesions of Gongjin cancer in the end,and then can effectively guide the treatment of the disease and determine the prognosis of the disease.4.The FIGO staging and pTNM staging 5-year survival rate and 5-year disease-free survival rate were gradually reduced with the increase of other periods,pTNM staging has a clear prognostic value for early cervical cancer.