Abstract: Objective: To investigate the influencing factors associated with pelvic lymph node metastasis (PLNM) in stage ⅠB to ⅡB cervical cancer. Methods: Clinical data of 630 patients with stage ⅠB to ⅡB cervical cancer treated with surgery were retrospectively studied. The PLNM condition of each patient was abstracted and the influencing factors of PLNM were analyzed by χ2, Mann-Whitney U test and multivariate logistic regression analysis. Results: 27.9% (176/630) patients had PLNM. Among 754 metastatic lymph nodes, 74.8% (564/754) of them were located in parametrial/obturator region. Result of univariate analysis suggested clinical stage, cell differentiation, uterine involvement, lymphovascular space invasion (LVSI), depth of stromal invasion, the level of SCC-Ag and CA125 were associated with PLNM (both P＜0.05). The multivariate analysis suggested low cell differentiation (OR=3.874, 95%CI: 1.100-13.646, P=0.035), deep 1/3 stromal invasion (OR=2.735, 95%CI: 1.675-4.466, P＜0.001) and LVSI (OR=73.822, 95%CI: 22.304-244.336, P＜0.001) were the independent risk factors of PLNM. Conclusions: Parametrial/obturator region are the most vulnerable areas of PLNM in cervical cancer. Patients with low cell differentiation, deep stromal invasion and LVSI are associated with a high risk of PLNM. In clinical treatment, surgeon should ensure the parametrial-excision range, and the implementation of systemic lymphadenectomy.

Key words: Uterine cervical neoplasms, Lymph nodes, Lymphatic metastasis, Cell differentiation, Neoplasm invasiveness