早期宫颈癌FIGO分期与手术病理分期的差异性分析

冯传宝

[摘要] 目的 探讨早期宫颈癌FIGO分期与手术病理分期的差异性因素。 方法 选择2010年1月～2016年6月在我院诊断治疗的早期宫颈癌患者238例的临床资料进行回顾性分析。所有患者均行广泛性全子宫切除术+盆腔淋巴结清扫术治疗。比较术前FIGO分期与手术病理分期结果。 结果 术前FIGO临床分期与手术病理分期对比，术前FIGO分期为ⅠB期与手术病理分期相符率最高，其次为ⅠA期、ⅡA期、ⅡB期最低，各组间比较差异显著（P<0.05）；ⅠB期与ⅡA期、ⅡB期的相符率比较，差异有统计学意义（P<0.05）。相关性分析显示，FIGO分期与手术病理分期具有相关性（r=0.4442）。随着术前FIGO分期的升高，淋巴结转移率呈上升趋势，ⅡB期淋巴结转移率显著高于ⅠA期、ⅠB期及ⅡA期（P<0.05）。 结论 FIGO临床分期具有简便可行，实用性强等优点，在一定程度上能够反映预后。

[关键词] 早期宫颈癌；FIGO分期；病理分期；差异性

[中图分类号] R737.33 [文献标识码] B [文章编号] 1673-9701（2017）22-0100-03

[Abstract] Objective To explore the difference factors of FIGO staging and surgical pathology staging in early cervical cancer. Methods The clinical data of 238 patients with early cervical cancer who were diagnosed and treated in our hospital from January 2010 to June 2016 were retrospectively analyzed. All patients underwent extensive hysterectomy and pelvic lymphadenectomy. The preoperative FIGO staging and surgical pathology staging results were compared. Results The preoperative FIGO clinical staging was compared with the operative pathological staging. The preoperative FIGO stagingⅠB period reached the highest match rate with the surgical pathological staging， followed byⅠA period， ⅡA period， with the lowest of ⅡB period. And the difference between the groups was significant（P<0.05）. There was a significant difference betweenⅠB period andⅡA period， ⅡB period（P<0.05）. Correlation analysis showed that FIGO staging was significantly correlated with surgical pathological staging（r=0.4442）. With the increase of preoperative FIGO staging， the lymph node metastasis rate increased， and the lymph node metastasis rate in stage ⅡB was significantly higher than that in stage ⅠA， stage ⅠB and stage ⅡA（P<0.05）. Conclusion FIGO clinical staging has the advantages of simplicity， feasibility and practicality and so on， which can reflect the prognosis to a certain extent.

[Key words] Early cervical cancer； FIGO staging； Pathological staging； Differences

宮颈癌是女性常见的恶性肿瘤，危及女性群体健康。随着诊疗技术的发展，宫颈癌患者的生存率也得到显著改善。手术病理分期是癌症治疗方案的选择主要依据，而宫颈癌治疗方案的选择目前临床上仍然参考FIGO（国际妇产科联盟）分期，该分期操作简单，通过双合诊、三合诊等方法简单评估癌症是否浸润子宫旁组织、阴道、膀胱、直肠、盆腔等，适应性强，操作简单[1，2]。这种分期方法的缺点是与医生个人经验密切相关，受医生主观影响较大，可导致一定的偏差，准确度、可信度下降。本研究分析早期宫颈癌FIGO分期与手术病理分期的差异，以期为临床诊断及治疗提供参考。现报道如下。

1资料与方法

1.1 一般资料

选择2010年1月～2016年6月在我院诊断治疗的早期宫颈癌患者238例的临床资料进行回顾性分析。纳入标准：宫颈癌为原发肿瘤，经组织学检查或者手术明确宫颈癌诊断，临床分期为ⅠA～ⅡB期，采用广泛全子宫切除术+盆腔淋巴结清扫术治疗。……