宫颈癌淋巴结转移的研究进展
Research Progress on Lymph Node Metastasis in Cervical Cancer
DOI: 10.12677/acm.2025.1592590, PDF,    科研立项经费支持
作者: 王 娟, 彭亚楠, 崔晨阳：石河子大学医学院，新疆 石河子；李福霞*, 周小铃*：石河子大学第一附属医院妇科，新疆 石河子
关键词: 宫颈癌；HPV；分子机制；淋巴结转移；Cervical Cancer； HPV； Molecular Pathogenesis； Lymph Node Metastasis
摘要: 宫颈癌是全球女性中最常见的恶性肿瘤之一，其主要病因是高危型人乳头瘤毒(HPV)感染。淋巴结转移是宫颈癌的重要转移途径，影响疾病的分期、治疗策略和预后。本文系统综述了宫颈癌淋巴结转移的临床病理特征、诊断评估方法、分子机制及治疗策略的最新研究进展。早期宫颈癌的淋巴结转移率较低，而晚期患者的转移率显著增加。临床研究表明，淋巴结转移发生率随临床分期进展而显著升高，主要危险因素包括肿瘤直径 ≥ 4 cm、深间质浸润、淋巴血管侵犯(LVSI)等。目前诊断主要依赖影像学检查(MRI, PET-CT)和前哨淋巴结活检，但其对微转移的检测仍存在局限。分子机制研究揭示了多步骤转移过程：上皮–间质转化(EMT)促进肿瘤细胞迁移；血管内皮生长因子C信号通路介导淋巴管生成；免疫检查点参与免疫逃逸；miRNA和lncRNA调控表观遗传改变。治疗方面，早期患者可采用前哨淋巴结清扫手术，中晚期以同步放化疗为主，而靶向治疗和免疫治疗在临床试验中展现出潜力。未来研究应整合人工智能等前沿技术，开发新型生物标志物，优化个体化治疗方案，以改善患者预后。通过多学科交叉融合，有望实现宫颈癌淋巴结转移的精准诊疗。
Abstract: Cervical cancer is one of the most common malignant tumors among women worldwide, with high-risk human papillomavirus (HPV) infection being its primary etiology. Lymph node metastasis (LNM) is a critical pathway for cervical cancer dissemination, significantly influencing disease staging, therapeutic strategies, and prognosis. This article systematically reviews recent advances in the clinicopathological characteristics, diagnostic evaluation methods, molecular mechanisms, and treatment strategies for cervical cancer LNM. The incidence of LNM is relatively low in early-stage cervical cancer but increases markedly in advanced cases. Clinical studies demonstrate that the rate of LNM rises significantly with disease progression, with key risk factors including tumor diameter ≥ 4 cm, deep stromal invasion, and lymphovascular space invasion (LVSI). Current diagnostic approaches primarily rely on imaging modalities (MRI, PET-CT) and sentinel lymph node biopsy (SLNB), though limitations remain in detecting micrometastases. Molecular studies have elucidated a multi-step metastatic cascade: epithelial-mesenchymal transition (EMT) facilitates tumor cell migration; the vascular endothelial growth factor-C (VEGF-C) signaling pathway mediates lymphangiogenesis; immune checkpoints participate in immune evasion; and miRNAs/lncRNAs regulate epigenetic modifications. Therapeutically, SLNB is feasible for early-stage patients, while concurrent chemoradiotherapy (CCRT) remains the mainstay for locally advanced disease. Emerging targeted therapies and immunotherapies show promising potential in clinical trials. Future research should integrate cutting-edge technologies like artificial intelligence (AI) to develop novel biomarkers and optimize personalized treatment regimens, thereby improving patient outcomes. Through multidisciplinary collaboration, precision medicine for cervical cancer LNM may be achieved.
文章引用：王娟, 彭亚楠, 崔晨阳, 李福霞, 周小铃. 宫颈癌淋巴结转移的研究进展[J]. 临床医学进展, 2025, 15(9): 1044-1052. https://doi.org/10.12677/acm.2025.1592590

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