침윤성 자궁경부암 환자에서 임파절 전이시 제 예후인자의 분석

Abstract

[한글]

침윤성 자궁경부암 환자에서 일차 치료후 치료실패 즉 잔류나 재발을 초래하는 고위험 예후인자 중에서 임파절 전이 여부가 치료실패와 밀접한 관련이 있다는 것은 잘 알려져 있으며 이의 방지를 위하여 일차 치료에 첨가하여 다양한 보조요법이 시도되고 있다. 197

6년 1월부터 1990년 5월까지 연세대학교 의과대학 산부인과에 입원하여 치료전 개복에 준한 수술적 치료를 받은 침윤성 자궁경부암 환자중 임파절 전이 유무가 확인된 179예를 대상으로 하여 다른 고위험 예후인자들과의 상관관계를 조사해 본 결과 13.7%(25예)에서 임파절 전이가 있었고 대상환자의 연령은 40대가 가장 많았고 연령에 따른 임파절 전이율은 차이를 보이지 않았으며, 병소의 크기가 클수록 세포 형태가 소세포형 등 LUNK(largr cell non-keratinizing)이외의 세포형태 일 때 자궁경부 실질내 암세포 침윤이 깊고 림프 혈관 침윤이 있을 때 그리고 임파절 형태가 lymphocyte depletion일 때 유의하게 임파절 전이율이 높았다. 또한 자궁경부 실질내 림프구 및 형질세포 침윤정도가 적을수록 임파절 전이율이 높았으나 통계적으로 유의하지 않았다.

The Analysis of Risk Factors Influencing Lymph Node Metastasis in Invasive

Carcinoma of the Cervix

HYUNG MIN CHOI

Department of Obsterics and Gynecology The Graduate School,

Yonsei University

(Directed by Professor Tchan Kyu Park M.D.)

It is well known that in patients with invasive carcinoma of the cervix high risk

factors such as lymph node metastasis are closely related t? treatment fai lurers

caused by residual cancer or recurrent cancer after primary treatment. To prevent

this, additional supportive measures are belong conducted with the primary

treatment modality. One hundred and seventy nine patients who underwent

pretreatment 1aparotomy for invasive cervix cancer, and who were confirmed as

having lymph node metastasis, were studied for high risk factors at the Yonsei

University College of Medicine, Severance Hospital, Department of Obstetrics and

Gynecology from January 1976 to May 1990.

The results showed that in 13.7%(25 cases) of the cases, 1ymph node metastasis

was present, and the patients in their 5th decade comprised the most common age

group. There was no relationship between age and lymph node metastasis rate .The

lymph node metastasis rate was significantly higher in patients with cancer that

was larger in leison size, of cell types other than large cell non-keratinizing

such as small cell type, with deeper invasion, with lymphovascular invasion, and

with lymphocyte depletion in lymph node morphology. Also mild infiltration with

lymphoplasmacyte was correlated with the higherlymph node metastasis rate, but was

not stastistically significant.

[영문]

It is well known that in patients with invasive carcinoma of the cervix high risk factors such as lymph node metastasis are closely related t? treatment fai lurers caused by residual cancer or recurrent cancer after primary treatment. To prevent this, additional supportive measures are belong conducted with the primary treatment modality. One hundred and seventy nine patients who underwent pretreatment 1aparotomy for invasive cervix cancer, and who were confirmed as having lymph node metastasis, were studied for high risk factors at the Yonsei University College of Medicine, Severance Hospital, Department of Obstetrics and

Gynecology from January 1976 to May 1990.

The results showed that in 13.7%(25 cases) of the cases, 1ymph node metastasis was present, and the patients in their 5th decade comprised the most common age group. There was no relationship between age and lymph node metastasis rate .The lymph node metastasis rate was significantly higher in patients with cancer that was larger in leison size, of cell types other than large cell non-keratinizing such as small cell type, with deeper invasion, with lymphovascular invasion, and with lymphocyte depletion in lymph node morphology. Also mild infiltration with

lymphoplasmacyte was correlated with the higherlymph node metastasis rate, but was not stastistically significant.