Analysis of the related factors of pelvic lymph node metastasis in patients with IA-IIB cervical carcinoma

Objective To investigate the distribution and the related factors of pelvic lymph node metastasis in patients with cervical carcinoma of stagesⅠA-ⅡB.Methods The clinical data of 149cases of patients with stageⅠAⅡB cervical cancer,who underwent pervasive hysterectomy and lapaparoscopic pelvic lymphyadenectomy,were retrospectively analyzed.Then,the distribution of pelvic lymph node metastases of uterine cervical carcinoma as well as the correlation of pelvic lymph node metastases of uterine cervical carcinoma with clinical stages,primary lesion,deep muscle infiltration of cervix,the SCC-Ag levels before treatment,the ages of patients,the course of disease,human papilloma virus(HPV),pathological differentiation,histological type,the growth pattern,and the vaginal fornix involvement were analyzed.Results The analysis of simple factorχ2 revealed that the pelvic lymph node metastases of uterine cervical carcinoma was related to clinical stages,primary lesion,deep muscle infiltration of cervix,and the SCCAg levels before treatment(P 0.05or 0.01),but it was not relate to the ages of patients,the course of disease,human papilloma virus(HPV),pathological differentiation,histological type,growth pattern,and vaginal fornix involvement(P 0.05).The overall pelvic lymph node metastasis rate was 24.16%(36/149)and the obturator lymph nodes were the most frequently involved,with the rate of 85.71%.Patients with lymph node metastasis in other parts of the body inclined to have obturator lymph node metastasis.Conclusion Clinical stages,tumor volume,deep muscle infiltration of cervix and the SCC-Ag levels(≥4μg/L)before treatment are positively correlated with the pelvic lymph node metastases of uterine cervical carcinoma.Lymph node metastasis is distributed mainly over the obturator foramen area,and obturator lymph nodes may be the sentinel lymph node of cervical cancer.However,if the sentinel lymph node biopsy was used to replace the pelvic lymphadenectomy,its feasibility and safety should be multi-facetedly evaluated by large series of prospective studies.