| Objective:The purpose of this study was to investigate the relationship between perineural invasion and prognosis of patients with early cervical cancer.Method:Search published in Pub Med,The Cochrane Library(Issue 2020),Embase,China How Net,Wanfang,CBM,VIP databases to collect case-control studies on PNI and early cervical cancer prognosis,language selection English,Chinese,time For the self-built database to January 2020,two reviewers independently screened the literature,extracted the hazard ratio(HR)and 95%confidence interval(95% CI)in the literature to calculate the effect size,and used Stata12.0 software perform data analysis.Result:Our meta analysis included a total of 11 articles,10 case-control studies,a total of 2122 patients,289 positive and 1833 negative patients with perineural invasion.The results of meta analysis showed that there was no significant difference in progression-free survival between the nerve invasion positive group and the nerve invasion negative group(DFS(HR=1.45,95%CI:0.98-2.14)),while the overall survival time of the perineural invasion group was significantly lower than that of the nerve invasion negative group(OS(HR=2.03,95%CI: 1.41-2.93)).Conclusion:The prognosis of early cervical cancer patients with positive nerve invasion is worse than that of patients with negative nerve invasion,and nerve invasion can be considered as an index affecting the prognosis of cervical cancer.Objective:To explore the correlation between peripheral perineural invasion(PNI)and clinical and pathological factors of early cervical cancer,and to establish nomogram to predict the risk of perineural invasion in early cervical cancer.Method:The clinical and pathological data of 418 patients with IB1-IIA2 cervical cancer who underwent radical hysterectomy in our hospital from January 2016 to December 2019 were retrospectively analyzed.S-100 immunostaining was used to diagnose PNI.Univariate and multivariate Logistic regression analysis was used to determine the high risk factors of neural invasion in patients with early cervical cancer.The hazard ratio(HR)and 95%confidence interval(95%CI)were calculated.An nomogram model of perineural invasion risk in early cervical cancer was established.receiver operating characteristic curve(ROC)was used to evaluate the prediction performance of the model.Kaplan-Meier was used to calculate the recurrence free survival(RFS)of patients and Log-rank test was performed.Result:The incidence of PNI in 418 cervical cancer patients was23.7%(99/418).Univariate analysis showed that PNI positive was closely related to clinical stage,pathological grade of medium and low differentiation,tumor maximum diameter ?4cm,invasion depth > 1/2,lymph-vascular space invasion(LVSI),lymph node metastasis,and the difference was statistically significant,but had nothing to do with age and pathological type.Multivariate analysis showed that clinical stage,moderate and low differentiation of pathological grade,infiltration depth > 1/2 and LVSI were independent risk factors of cervical cancer PNI P<0.05.the influence grade and score of these four independent risk factors included in nomogram model based on Logistic regression model were clinical stage: grade 1 and 100 respectively.Pathological grade: 2,85 points;The infiltration depth and LVSI are both grade 3,75 points.The lower receiver operating characteristic curve area of nomogram model is0.74,explain predictable performance.The recurrence rate of PNI positive group is higher than that of PNI negative group.The tumor-free survival time of PNI positive group is significantly lower than that of negative group(P=0.000).Conclusion PNI is closely related to cervical cancer clinical stage,pathological grade of medium and low differentiation,tumor maximum diameter ?4cm,invasion depth > 1/2,LVSI and lymph node metastasis.Multivariate analysis shows that clinical stage,pathological grade of medium and low differentiation,invasion depth > 1/2 and LVSI are independent risk factors for cervical cancer PNI occurrence,and cervical cancer PNI positive may be a potential adverse prognostic factor.In addition,PNI is also associated with recurrence,which significantly reduces RFS.The nomogram based on clinical stage,pathological grade,medium and low differentiation,invasion depth > 1/2 can be used to guide the further treatment of early cervical cancer patients with PNI. |
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