Correlation analysis of perineural invasion and prognosis in cervical squamous carcinoma / 肿瘤研究与临床

ABSTRACT

Objective To investigate the relationship between perineural invasion (PNI) and clinicopathological features as well as the prognosis of cervical squamous carcinoma. Methods The clinico-pathological data of 256 patients with cervical squamous carcinoma (ⅠB1-ⅡA2) treated with extensive resection and pelvic lymphadenectomy in Shanxi Provincial Cancer Hospital from January 2010 to December 2013 were retrospectively analyzed. PNI of tumor area in the pathological sections was observed by using microscope. The relationship between PNI and clinicopathological features was analyzed. The effect of PNI on postoperative 5-year survival was also analyzed. Results There were 22 (8.6％) cases of PNI among 256 patients with cervical squamous carcinoma. PNI-positive had a relation with tumor stage, depth of invasion, lymphovascular space invasion (LVSI), and lymph node metastasis (all P < 0.05). Multivariate logistic regression showed that positive lymph node metastasis was an independent risk factor for PNI (OR = 3.89, 95％ CI 1.50-10.12, P =0.005); infiltration depth > 1/2 might be an independent risk factor for PNI (OR = 7.30, 95％ CI 0.91-58.74, P = 0.062). The 5-year total survival rate was 89.9％ for 256 patients with cervical squamous carcinoma. And the 5-year total survival rate of PNI-positive patients was lower than that of PNI-negative patients (50.3％ vs. 93.4％). Cox regression showed that PNI-positive was a risk factor for 5-year total survival (HR = 9.73, 95％CI 4.31-21.98, P < 0.01); after adjusting the relevant clinicopathological features, PNI-positive was still a risk factor of 5-year total survival (HR = 8.12, 95％ CI 2.47-26.73, P = 0.001). Conclusions The occurrence of PNI in cervical squamous carcinoma of ⅠB1 -ⅡA2 is associated with clinical stage, depth of invasion, LVSIand lymph node metastasis. PNI-positive may be a new risk factor for the prognosis of cervical squamous carcinoma.