目的：通过总结宫颈癌患者病例资料，分析腹主动脉旁淋巴结（para-aortic lymph node，PALN）转移的相关因素并建立预测模型，为淋巴结切除手术决策提供参考。方法：将本院妇产科2010年1月至2019年12月期间诊治的248例宫颈癌患者作为研究对象，采用回顾性研究方法，分析入组病例一般资料及手术病理资料，使用单因素和Logistic多因素回归分析影响PALN转移的危险因素，建立预测模型。结合当前研究和临床证据，探讨淋巴结切除手术原则和切除范围。结果：248例宫颈癌患者平均（49.06±9.97）岁，平均体重指数（24.43±3.71） kg·m^-2，其中19例发生PALN转移，占比7.66%。单因素分析结果显示，宫颈癌患者PALN转移与临床分期（IIA期）、分化程度（低分化）、病灶直径（≥ 4 cm）、肌层浸润（≥ 1/2）、淋巴脉管浸润（lymphovascular invasion，LVSI）以及盆腔淋巴结（Pelvic lymph node，PLN）转移相关（P<0.05）。Logisitic多因素回归分析结果显示，病灶直径≥ 4 cm、LVSI以及PLN转移为独立危险因素（P<0.05）。回归方程为Logit P=-5.676+2.524×PLN转移+1.849×LVSI+1.429×病灶直径。宫颈癌患者PALN转移概率的ROC曲线面积（AUC）为0.859（95%CI 0.758~0.960）；截断值取0.566时较理想，此时预测灵敏度为68.4%，特异度为88.2%。结论：病灶直径≥ 4 cm、LVSI、盆腔淋巴结转移为影响宫颈癌患者PALN转移的独立危险因素，所得预测模型有较好的价值，建议合并存在上述危险因素宫颈癌患者实施PALN切除。

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