ABSTRACT
Objective:To explore the distribution of pelvic lymph node (PLN) metastasis and the correlative dangerous factors in early cervical cancer patients.Methods:The medical records of 508 patients who underwent extensive hysterectomy and lymphadenectomy for International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰb-Ⅱb cervical cancer in Guizhou Provincial People`s Hospital were reviewed retrospectively.Results:There were 278 patients with stage Ⅰb cervical cancer, 204 patients with stage Ⅱa cervical cancer and 26 patients with stage Ⅱb cervical cancer; the positive rate of lymph node metastasis was 16.7%(85/508), and obturator lymph node metastasis was the most common (56.6%); there were 19 patients with bilateral lymph node metastasis, accounting for 22.35%(19/85); lymph node metastasis occurred 104 times (two times for bilateral simultaneous transfer), and jumping lymph node metastasis accounted for 37.5%(39/104); common iliac lymph node metastasis accounted for 18.3%(19/104). The metastasis rate of patients with stage Ⅱa and Ⅱb (including parametrial, lymph node, ovarian and oviduct metastasis) was higher than that of patients with stage Ⅰb, and the odd ratio ( OR) was 2.30 and 2.48 respectively ( P<0.05); the metastasis rate of patients with moderately differentiated tumors was significantly higher than that of patients with well differentiated and poorly differentiated tumors ( P<0.05). There was no significant difference in the positive rate of pelvic lymph node metastasis among patients with different ages and histological types ( P>0.05); the positive rate of pelvic lymph node metastasis in patients with stage Ⅱa and Ⅱb was higher than that in patients with stage Ⅰb with statistically significant difference ( P<0.05); the positive rate of pelvic lymph node metastasis in patients with moderately differentiated tumors was higher than that in patients with well differentiated and poorly differentiated tumors, with statistically significant difference ( P<0.05). Conclusions:Obturator lymph node metastasis is the most common in cervical cancer. The risk of lymph node metastasis is increased in patients with stage Ⅱa or moderately differentiated tumors. Jumping metastasis is also a common way of metastasis, which suggests that standard and complete lymph node resection is an important measure to ensure the curative effect.
ABSTRACT
Objective To explore the prevalence trend of male prostate cancer mortality in China during the 25 years from 1992 to 2017. Methods The age-period-cohort (APC) model and the Intrinsic Estimator (IE) algorithm were used to estimate the age effect, period effect and cohort effect of prostate cancer mortality risk in Chinese men. Results The overall mortality rate of prostate cancer in Chinese men was on the rise from 1992 to 2017, with the crude mortality rate rising from 3.39‰ to 7.17‰. The results of the APC model analysis showed that the age effect of prostate cancer mortality increased with age in Chinese men after the age of 40. The period effect was generally on the rise. The cohort effect indicated that men born in China after 1980 experienced a declining risk of prostate cancer death. Conclusions The period effect of prostate cancer mortality risk was dominant in Chinese men. Changes in lifestyle and sexual attitudes, population aging, smoking, environmental pollution and other factors may be the main reasons for the increase in the period effect. The attention should be paid to improve these aspects in the prevention and treatment of prostate cancer, and at the same time the awareness rate of PSA screening should be strengthened. Comprehensive prevention with health education can help reduce overall prostate cancer mortality in men.