摘要
目的:探讨与Ⅰ期子宫浆液性癌(USC)预后相关的生物学行为因素,旨在帮助指导术后辅助治疗方案的制定。方法:回顾性分析了我院2009—2018年期间收治的Ⅰ期USC患者的临床病理特征、治疗及预后情况。结果:共纳入67例患者,完成随访56例(84%),Ⅰ_(A)期36例(64%),Ⅰ_(B)期20例(36%);21例(38%)USC,35例(63%)为含有USC成分的混合癌。中位随访时间132.7个月,6例患者出现复发转移,5例死亡。复发组与未复发组在FIGO分期、肿瘤分级、病灶浸润深度、身高、体重上差异有统计学意义(均P<0.05);在Ⅰ_(B)期患者中复发组与未复发组在术后辅助治疗方式、治疗前CA125值、身高、体重上差异有统计学意义(均P<0.05)。单因素分析显示身高、体重、体重指数、治疗前CA125值与预后相关(均P<0.05)。结论:USC生物学行为高度恶性,即使是Ⅰ_(A)期,仍建议术后化疗以预防远处转移,放疗的获益仍有争议。对于Ⅰ_(B)期,在化疗基础上联合放疗可能有利于降低复发率。瘦小体型、治疗前CA125>43 U/ml与预后不良有关,也许可作为早期USC的危险因素,指导术后辅助治疗方案的制定。
Objective:To investigate the prognostic factors of stageⅠuterine serous carcinoma(USC),and help to plan the postoperative adjuvant treatment.Methods:We retrospectively analyzed the clinicopathological features,treatment and prognosis of stageⅠUSC patients in our hospital between 2009 and 2018.Results:A total of 67 patients were enrolled and 56 cases were followed up.36 cases(64.3%)were in stageⅠ_(A),and 20 cases(35.7%)were in stageⅠ_(B);21 cases(37.5%)were USC,and 35 cases(62.5%)were mixed carcinoma with USC.The median follow-up time was 132.7 months.6 patients had recurrence,and 5 patients died.There were statistically significant differences in FIGO stage,tumor grade,depth of myometrial invasion,height and weight between recurrence group and non-recurrence group(P<0.05);in stageⅠ_(B),there were significant differences in postoperative adjuvant therapy,CA125 value before treatment,height and weight between recurrence group and non-recurrence group(P<0.05).Univariate analysis showed that height,weight,body mass index(BMI)and CA125 value before treatment were correlated with prognosis(P<0.05).Conclusions:USC is highly malignant in biological behavior,so even for stageⅠ_(A)patients,we suggest postoperative chemotherapy to prevent distant metastasis,and the benefit of radiotherapy is still controversial;for stage IB,chemotherapy combined with radiotherapy may reduce the recurrence rate.Small body size and CA125>43 U/ml before treatment are associated with worse prognosis,so they may be used as risk factors for early stage of USC to guide the postoperative adjuvant treatment.
作者
王登凤
彭春蓉
刘欣
张国楠
Wang Dengfeng;Peng Chunrong;Liu Xin;Zhang Guonan(Gynecologic Oncology Center,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,China;Southwest Medical University,Luzhou 646000,China)
出处
《中华转移性肿瘤杂志》
2020年第4期278-282,共5页
Chinese Journal of Metastatic Cancer
作者简介
通信作者:张国楠,Email:zhanggn@hotmail.com
