The Effect Of Uterine Tumor Infiltration On Prognosis Of Patients With Cervical Cancer

Objective: To explore the clinical features and related risk factors of patients with cervical cancer and uterine tumor invasion;and to discover the impact of cervical cancer and uterine tumor invasion on the prognosis of patients with cervical cancer,and provide evidence for postoperative adjuvant treatment of cervical cancer.Methods: In this experiment,a retrospective case-control analysis method was used to analyze the clinical data of patients with IA2-IIIC2 cervical cancer 2018 FIGO staging from 2003 to 2016 in Anhui Province Hospital,and the patients were classified as positive for uterine tumor infiltration Group and negative group,compare the clinical pathological data of the two groups;and analyze the factors affecting the prognosis of patients after cervical cancer surgery.The inclusion criteria are: cervical cancer patients who were diagnosed in the Department of Obstetrics and Gynecology of Anhui Hospital before December 31,2016;primary cervical cancer was confirmed by pathological examination;clinical pathological staging was IA2-IIIC2 patients(according to 2018 FIGO Staging)For initial treatment,patients who have not received neoadjuvant chemotherapy or radiotherapy;patients with complete pathological data of patients undergoing total hysterectomy;patients with complete contact information.Collect patient’s general information and clinicopathological data,including name,age,hospitalization number,contact information,operation method,tumor size,Pathological type,degree of differentiation,lymphatic vascular invasion(lymphovascular space involvement,LVSI),the number of lymph nodes removed and the number of metastases in each region,the depth of cervical infiltration,the scope of vaginal fornix invasion,parauterine invasion,etc.The surgical methods are divided into open and There are two types of laparoscopy.Statistical analysis was performed using SPSS26.0 statistical software.The positive and negative groups of uterine tumor infiltration were compared and analyzed.Chi-square test was used for univariate analysis,and Logistic regression analysis was used for multivariate analysis.Kaplan-The Meier method was used for survival analysis,the log-rank test was used for univariate analysis,and the COX risk regression model was used for multivariate analysis.P<0.05 was defined as statistically significant.Results: A total of 522 cervical cancer patients were enrolled,with an average age of44 years.Among them,360 were 40-55 years old,accounting for 68.80%,108 were less than or equal to 40 years old,accounting for 20.60%,and 54 were older than 55,accounting for 10.30%.In the year of diagnosis,there were 44 persons in 2008-1990,accounting for 8.4%;in 2012-2008,there were 84 persons,accounting for 16%;in2016-2013,there were 394 persons,accounting for 75.40%.The number of IA1-IB3 patients reached 242,accounting for 46.30%.There were 15 people in IIA1-IIB,accounting for 2.7%,and the number of IIIC1-IIIC2 was 265,or 50.70%.The maximum diameter of the tumor was classified according to the 2108 new staging,with2 cm and 4cm as the boundary.Among them,there are 5 patients with the largest diameter less than 2cm,accounting for 0.9%;148 patients with the largest diameter of2-4cm,accounting for 28.30%;the largest diameter There are 356 people who are larger than 4cm and 64 people.The pathological types are divided into squamous cell carcinoma,adenocarcinoma and adenosquamous carcinoma and others.Among them,there are 453 cases of squamous cell carcinoma,accounting for 86.70%,52 cases of adenocarcinoma,accounting for 9.9%;9 cases of adenosquamous carcinoma,accounting for 1.7%;other types There are 8 people,accounting for 1.5%.The pathology classification is divided into three levels,of which 62 people are at level 1,accounting for 11.80%;there are 188 people at level 2,accounting for 36%;there are208 people at level 3,accounting for 39.80%;the unknown is 64 people.Accounted for12.20%.Surgical methods are divided into laparoscopy and laparotomy.Among them,235 patients undergo laparotomy,accounting for 45%;there are 287 laparoscopy patients,accounting for 54.90%.There were 27 people with uterine body infiltration positive,which was 5.10%;495 people were negative,which accounted for 94.80%;117 people were LVSI positive,which accounted for 22.40%;and 405 people were negative,which accounted for 77.50%.There were 7 patients with positive resection margin,accounting for 1.3%,515 patients with negative resection margin,accounting for 98.60%;5 patients with positive parauterine infiltration,accounting for 0.90% of the total;517 patients with negative parauterine infiltration,accounting for 99%.There are2 people with positive ovarian metastasis,accounting for 0.3%;520 people with negative,accounting for 99.60%;lymph node metastasis includes pelvic lymph node metastasis and abdominal main lymph node metastasis,of which 297 people have positive lymph node metastasis,accounting for 56.80%;lymph node metastasis is negative There are 225 people,accounting for 43.10%.Univariate logistic binary regression analysis showed that compared with patients without uterine corpus infiltration,the age,pathological type,surgical method and lymph node metastasis of patients with uterine corpus infiltration were statistically different from those with uterine corpus infiltration(P < 0.05).According to Logistic multivariate analysis,tumor infiltration of the uterus is still related to the age of onset and the type of pathological tissue.For survival analysis,the median follow-up time for the entire cohort was 108months: 86 months for the uterine body invasion group and 119 months for the noninvasive group.In the cohort,84 cases(16.1%)died of cervical cancer: 13 cases(48.1%)in the uterine corpus invasion group and 71 cases(14.3%)in the non-invasive group.In a multivariate analysis that controls age,race,marital status,histological type,tumor grade,T stage,tumor size,pelvic lymph node status,type of surgery,and type of adjuvant radiotherapy,compared with the group without uterine invasion,Uterine tumor invasion is still an independent prognostic factor for patients with cervical cancer.Conclusion:The positive uterine tumor invasion of cervical cancer has an increased risk of other high-risk factors.Positive uterine tumor invasion is a risk factor affecting the prognosis of patients with cervical cancer.