| Objective: Analysis of the general situation and the related clinical and pathological factors in patients with metastatic pelvic lymph nodes in early cervical squamous cell carcinoma,and to discuss the treatment level of serum squamous cell carcinoma antigen(SCC-Ag)in the lymph node metastasis value prediction,provide a reference for the treatment of early cervical cancer individualized.Methods: A retrospective analysis of from January 2014 to December 2016 in the First Affiliated Hospital of Bengbu Medical College Department of gynecology and gynecologic oncology treated by surgery(Transabdominal total hysterectomy and pelvic lymphadenectomy)clinical and pathological data with stage IA to IIA cervical squamous cell carcinoma,202 cases were included.Discussion in patients with lymph node metastasis,single factor analysis the relationship of patient age,clinical stage,tumor cell differentiation,tumor size,depth of stroma invasion,tumor growth,serum SCC-Ag levels between the 7 indexes and pelvic lymph node metastasis,logistic regression analysis was used to analyze the significant factors in univariate analysis.The SCC value of each patient before treatment was selected into the statistical software to draw the receiver operating characteristic(ROC)curve.Results: Among the 202 patients with stage IA to IIA cervical squamous cell carcinoma,the ages ranged from 27 to 74 years(mean age,48 years),with the highest incidence of 35-54 years old.There are 34 cases with pelvic lymph node metastasis in all patients,lymph node positive rate was 16.8%(34/202),the obturator lymph node metastasis in 24 cases,accounting for 11.9%,iliac lymph node metastasis in 22 cases,accounting for 10.9%;a single group of the lymph node metastasis rate was 64.71%(22/34),at least 2 groups of the lymph node metastasis rate was 35.29%(12/34).Independent of the lymph node metastasis rate was 50%(17/34),At least 2 lymph node metastasis rate was 50%(17/34).Single factor analysis showed that the clinical stage,tumor diameter,the depth of cervical interstitial infiltration,and the level of SCC-Ag before treatment were closely related to cervical lymph node metastasis(P<0.05);The age of patients,tumor growth and differentiation degree of tumor cells had an effect on the rate of lymph node metastasis,but there was no significant difference(P>0.05).Multivariate analysis showed that the level of SCC-Ag(P=0.002)and interstitial infiltration depth(P = 0.033)were significant independent risk factors for pelvic lymph node metastasis of stage IA to IIA cervical squamous cell carcinoma.ROC curve showed that the best predictive value of SCC-Ag before treatment was 3.05ng/ml.The Serum SCC-Ag before treatment to 3ng/ml as compared to group,The lymph node metastasis rate was significantly higher than that in group ?3ng/ml,which was 7.2 times higher than that in normal patients with SCC-Ag,and the difference was statistically significant(P=0.000).Conclusion: The rate of pelvic lymph node metastasis was 16.8% in stage?A to ?A cervical squamous cell carcinoma,and the highest rate of obturator lymph node metastasis.the level of SCC-Ag(P=0.002)and interstitial infiltration depth(P =0.033)were significant independent risk factors for pelvic lymph node metastasis of stage IA to IIA cervical squamous cell carcinoma.ROC curve showed that the best predictive value of SCC-Ag before treatment was 3.05ng/ml,as a predictor of lymph node metastasis of the reference specimen has certain feasibility. |
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