Analysis Of Related Factors Of Inguinal Lymph Node Metastasis In Penile Carcinoma

Objective: to screen out high-risk patients with inguinal lymph node metastasis by analyzing the correlation between various factors in penile cancer patients and whether inguinal lymph node metastasis will occur,and then take active treatment measures to improve the survival rate of patients.Selection methods: our hospital from 2010 to 2018,all patients with penile cancer surgery,a total of 110 cases,41 cases with lymph node metastasis,69 cases without lymph node metastasis,through the analysis of the statistical methods of penile cancer patients age,past medical history(whether merger to high blood pressure,diabetes or heart disease),the onset time,tumor pathological grading and staging,swelling lymph node number,diameter and so on various factors,and whether the correlation of inguinal lymph node metastasis happensResults: a total of 157 patients in this group were followed up successfully,with a follow-up rate of 70.1%(110/157),a follow-up period of 1-105 months,and a median follow-up period of 35 months.Among the 110 patients,the tumor-specific mortality was 17.3%(19/110)and the overall mortality was 27.3%(30/110).In this group of patients,the maximum diameter of inguinal enlarged lymph nodes was 72 cases < 1.5cm,among which 22 cases were pathologically confirmed with lymph node metastasis,and the positive rate of lymph node metastasis was 30.6%.The maximum diameter of inguinal enlarged lymph nodes was 1.5cm in 38 cases,among which 19 cases showed lymph node metastasis,and the positive rate of lymph node metastasis increased to 50%.The difference between the two groups was statistically significant(p=0.046).A total of 43 cases with Ta/T1 tumor staging were found,among which 10 cases were proved to have lymph node metastasis,and the positive rate of lymph node metastasis was 23.3%.A total of 67 patients with tumor pathological stage T2 or above were diagnosed,among which 31 cases showed lymph node metastasis,and the positive rate of lymph node metastasis was 46.3%.The difference between the two groups was statistically significant(p=0.015).The pathological grading was highly differentiated in 40 cases,among which 8 cases were confirmed with lymph node metastasis,with a positive rate of lymph node metastasis of 20%.Among the 66 cases with moderate differentiation,30 were confirmed with lymph node metastasis,and the positive rate of lymph node metastasis was 45%.The pathological grading was low differentiation in 4 cases,and lymph node metastasis was confirmed in 3 cases,with a positive rate of 75%.The difference was statistically significant(p=0.003).Through this analysis,we found that there was no significant correlation between the patient's age,previous history(whether combined with hypertension,diabetes and heart disease),time of onset,and the number of enlarged lymph nodes and whether lymph node metastasis would occur.The difference between the two groups was not statistically significant(P > 0.05).In addition,we also analyzed the specific mortality and overall mortality of each influencing factor,among which the pathological grade was 7.5%(3/40)for highly differentiated specific mortality,22.7%(15/66)for moderately differentiated specific mortality,and 25.0%(1/4)for poorly differentiated specific mortality.The difference was statistically significant(p=0.044)for the three groups.The overall mortality of the patients with high differentiation was 12.5%(5/40),the overall mortality of the patients with medium differentiation was 34.8%(23/66),and the overall mortality of the patients with low differentiation was 50.0%(2/4).The difference between the three groups was statistically significant(p=0.007).There was no significant difference in other factors(p > 0.05).Conclusion: age,previous history(whether combined with hypertension,diabetes,heart disease),time of onset,and number of enlarged inguinal lymph nodes were not correlated with lymph node metastasis in penile cancer patients.Groin swelling lymph nodes maximum diameter,tumor stage,tumor grade and penis carcinoma patients with lymph node metastasis or not relevant,and swollen lymph nodes maximum diameter,the greater the positive rate of lymph node metastasis is higher,the same tumor pathological stage,the higher the grading,lymph node metastasis and the higher positive rate,these three factors can be used as penile cancer lymph node metastasis predictor.With the increase of tumor grade(the degree of differentiation decreased),the specific mortality and the overall mortality also increased significantly.According to the preoperative imaging data and postoperative pathological report,for the enlarged lymph nodes with diameter greater than 1.5cm,the higher the grade(differentiation degree is low and medium),and the staging G2 or above,the significantly increased probability of lymph node metastasis in the future in such patients,and early intervention treatment can be considered.