Abstract: Objective To investigate the relationship between perineural invasion (PNI) and clinicopathological characteristics,  as well as its effects on prognosis of cervical cancer. Methods A total of 836 patients with cervical cancer who underwent radical hysterectomy plus pelvic lymphadenectomy at the Guangxi Medical University Cancer Hospital between October 2013 and April 2024 were retrospectively analyzed to analyze the relationship between PNI and clinicopathological characteristics of cervical cancer, as well as the factors influencing prognosis. Results Among the 836 patients, 172 were PNI positive, the positive rate of PNI was 20.6%. Univariable analysis revealed that clinical stage of cervical cancer, lymph⁃vascular space invasion (LVSI), lymph node metastasis, depth of stromal invasion, and parametrial invasion of cervical cancer might be related to the occurrence of PNI (all P<0.05). Multivariate analysis identified that LVSI, lymph node metastasis, depth of stromal invasion >1/2, parametrial invasion, and high clinical stage were independent risk factors for PNI (all P<0.05). The recurrence and mortality rates in the PNI⁃positive group were higher than those in the PNI⁃negative group (20.8% vs 9.6%; 20.1% vs 11.8%). Additionally, the 5⁃year progression⁃free survival rate and 5⁃year overall survival rate in the PNI⁃positive group were lower than those in the PNI⁃negative group (76.4% vs 88.0%, 74.2% vs 86.2%), and the differences were statistically significant (all P<0.05). Conclusions LVSI, lymph node metastasis, depth of stromal invasion >1/2 , parametrial invasion, and high clinical stage are independent risk factors for the occurrence of PNI. However, no significant correlation is found between PNI and the immunohistochemical indicators (p16 or Ki⁃67). Compared to PNI⁃negative patients, cervical cancer patients with positive PNI have a poorer prognosis. 

Key words: Cervical cancer, Perineural invasion, Immunohistochemical, Pathological characteristics, Prognosis