Background. Perineural invasion (PNI) is considered as a poor prognostic factor in cervical cancer, but there has been no postoperative adjuvant therapy for it, because whether it belongs to high- or intermediate-risk factors has not been determined, this study intends to provide evidences to solve this problem. Methods. We conducted a retrospective analysis of cervical cancer patients who underwent radical surgery and be reported PNI from January 2012 to June 2017 at the Sun Yat-sen University Cancer Center. After 1 : 1 propensity score matching (PSM), a group of patients without PNI was matched according to the clinical pathological features. Postoperative pathological parameters and prognosis were evaluated between the PNI and the matched groups. Results. 1836 patients were screened, of which 162 (8.8%) diagnosed as stages IB1 to IIB reported PNI. Comparing to the matched group, more PNI (+) patients had deep outer cervix stromal invasion, cervical tunica adventitia invasion, positive lymph nodes, and positive margins. Among patients without high-risk factors, PNI (+) patients had worse 3-year overall survival (90.8% vs. 98.1%, ), PNI (+) patients with single intermediate-risk factor and PNI (-) patients who meet with SEDLIS criteria had similar progress free survival () and overall survival (), even similar survival curves. Conclusion. PNI is related to a worse overall survival among cervical cancer patients without high-risk factors and play the role as an intermediate-risk factor.

中文翻译：

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神经周围浸润应被视为手术治疗宫颈癌复发的中间风险因素：倾向评分匹配研究

背景。神经周围浸润（PNI）被认为是宫颈癌预后不良的因素，但尚未对其进行术后辅助治疗，因为尚未确定其属于高危因素还是中危因素，本研究拟提供证据来解决这个问题。方法。我们对 2012 年 1 月至 2017 年 6 月在中山大学肿瘤中心接受根治性手术并报告 PNI 的宫颈癌患者进行了回顾性分析。1:1倾向评分匹配（PSM）后，根据临床病理特征匹配一组无PNI的患者。在PNI和匹配组之间评估术后病理参数和预后。结果. 筛查了 1836 名患者，其中 162 名（8.8%）被诊断为 IB1 至 IIB 期报告了 PNI。与对照组相比，更多的PNI（+）患者出现宫颈外间质受累、宫颈外膜受累、淋巴结阳性和切缘阳性。在没有高危因素的患者中，PNI (+) 患者的 3 年总生存率较差（90.8% 对 98.1%，)，具有单一中危因素的 PNI (+) 患者和符合 SEDLIS 标准的 PNI (-) 患者具有相似的无进展生存期 ()和总生存期 ()，甚至相似的生存曲线。结论。PNI与没有高危因素的宫颈癌患者的总体生存率较差有关，并起到中危因素的作用。