Clinical Analysis On The Risk Factors Of Parametrial Involvement In Early-stage Cervical Cancer

Objective:To investigate the risk factors of Parametrial involvement in Patients with early-stage cervical cancer,to ex Plore the low risk factors,and to hel P figure out Patients suitable for less radical surgery,so that to reduce the occurrence of the com Plication ha PPened during and after surgery and also to im Prove the quality of Patients' life.Methods: We retros Pectively reviewed the clinical and Pathological information of387 Patients with early-stage cervical cancer treated in the International Peace Maternity &Child Health Hos Pital Affiliated to Shanghai Jiao Tong University during January 2010 and August 2016.All Patients underwent extensive hysterectomy and Pelvic lym Ph node dissection and were diagnosed of stage?A1-?A2 cervical cancer by FIGO.The risk factors of Parametrial involvement in early-stage cervical cancer were evaluated by using univariate and multivariate analyses.We use the ROC curve to assess the value of the indicators before o Peration,such as age,clinical stage,SCC-Ag,and the tumor size measured by MRI.Results: Of 387 Patients,17(4.4%,17/387)had Parametrial involvement.The univariate analysis indicated that the clinical Stage(P=0.005),tumor size(P=0.003),serum squamous cell carcinoma antigen(SCC-Ag)level(P=0.045),fibrinogen level(P?0.01),de Pth of tumor invasion(P?0.01),lym Phatic vascular invasion(P?0.01),surgical size of vagina(P?0.01),surgical margin status of vagina(P?0.01),lym Ph node metastasis(P?0.01),and involvement of vagina(P?0.01)were the risk factors of early-stage cervical cancer.Multivariate analysis indicated that the de Pth of tumor invasion,lym Phatic vascular invasion and lym Ph node metastasis were inde Pendent risk factors of early-stage cervical cancer.Area under the curve(AUC)of the tumor size measured by MRI was 0.805(95% CI,0.561 to 1.000,P=0.012),and AUC of combination criteria was 0.817(95% CI,0.600 to1.000,P=0.009),which indicated the best Performance.Conclusion: The rate of Parametrial involvement in early-stage cervical cancer is com Paratively lower according to the Posto Perative Pathological results.The the de Pth of tumor invasion,lym Phatic vascular invasion and lym Ph node metastasis were the inde Pendent risk factors of Parametrial involvement in early-stage cervical cancer.Therefore,it is of great im Portance to evaluate the condition of the de Pth of tumor invasion,lym Phatic vascular invasion and lym Ph node metastasis before surgery.Patients who are without lym Phatic vascular invasion and lym Ph node metastasis,and less than 50% stromal invasion could be considered to have less radical surgery such as modified radical hysterectomy or sim Ple hysterectomy with Pelvic lym Phadenectomy.The combination criteria of age,clinical stage,SCC-Ag,and the tumor size measured by MRI indicated the best Performance.However,we still need to do more randomized clinical trait of large samPle to confirm this assumPtion.