【摘要】 目的:探究淋巴血管间隙浸润(LVSI)定量与早期宫颈腺癌临床特征及预后的相关性。方法:收集术前FIGO分期Ⅰa1期到Ⅰb2、Ⅱa1期宫颈腺癌患者，依据LVSI定量评估系统，将LVSI分为3个不同等级，分析LVSI定量与早期宫颈腺癌临床特征及预后的相关性。结果:宫颈腺癌LVSI定量与淋巴结(LN)转移差异有统计学意义(OR=4.216,95%CI为1.457～2.202,P=0.008)。中位随访时间79个月，Log-Rank结果显示，局灶LVSI与弥漫LVSI相比、弥漫LVSI与LVSI阴性相比，PFS、远处转移、OS差异有统计学意义(P<0.05)。Cox比例风险模型结果显示，LVSI定量与PFS、OS相关性差异有统计学意义(HR=2.366,95%CI为1.061～5.275,P=0.035;HR=2.489,95%CI为1.141～5.432,P=0.022)。结论:弥漫LVSI是早期宫颈腺癌LN转移的独立危险因素，与远处转移、OS、PFS相关；局灶LVSI及LVSI阴性呈现相似的复发转移模式。LVSI定量分类系统较传统二分类能更好地预测早期宫颈腺癌LN转移、远处转移、OS、PFS,有利于精准指导临床治疗。更多还原

【Abstract】 Objective:To explore the correlation between quantitative lymph vascular space invasion(LVSI) and clinical characteristics and prognosis in early cervical adenocarcinoma.Methods:Patients with cervical adenocarcinoma staged Ⅰa1 to Ⅰb2 and Ⅱa1 according to the FIGO staging system were collected preoperatively.Based on a quantitative LVSI assessment system, LVSI was classified into three different grades, and the correlation between LVSI quantification and clinical characteristics and prognosis in early cervical adenocarcinoma was analyzed.Results:There was a statistically significant difference between LVSI quantification in cervical adenocarcinoma and lymph node(LN) metastasis(OR=4.216,95%CI:1.457～2.202,P=0.008).With a median follow-up time of 79 months, the Log-Rank test showed statistically significant differences in progression-free survival(PFS),distant metastasis, and overall survival(OS) when comparing focal LVSI to diffuse LVSI,and diffuse LVSI to negative LVSI(P<0.05).The Cox proportional hazards model indicated that the correlation between quantitative LVSI and PFS and OS was statistically significant(HR=2.366,95%CI:1.061～5.275,P=0.035;HR=2.489,95%CI:1.141～5.432,P=0.022).Conclusion:Diffuse LVSI is an independent risk factor for LN metastasis in early cervical adenocarcinoma and is associated with distant metastasis, OS, and PFS.Focal LVSI and negative LVSI exhibit similar patterns of recurrence and metastasis.The quantitative LVSI classification system can better predict LN metastasis, distant metastasis, OS, and PFS in early cervical adenocarcinoma compared to the traditional dichotomous classification system, which is beneficial for precise guidance in clinical treatment.更多还原