摘要
目的 探讨影响ⅠB期和ⅡA期宫颈癌预后的高危因素。方法 1992年 12月～ 2 0 0 1年12月手术治疗的 111例宫颈浸润癌 ,中位年龄 4 0岁。按FIGO(1994 )分期标准 ,ⅠB期 80例 (ⅠB1期和ⅠB2期各 4 0例 ) ,ⅡA期 31例。鳞癌 93例 (83.8% ) ,腺癌 17例 (15 .3% ) ,小细胞癌 1例。 111例患者均采用广泛性子宫切除加以撕剥式为主的盆腔淋巴清扫术 ,术前辅助放疗 74例 (6 6 .7% ) ,术后辅助治疗 2 4例 (2 1.6 % )。生存率统计采用Kaplan Meier方法 ,预后相关因素分析采用Cox模型和 χ2 检验。结果 全组患者 5年生存率为 85 .9% ,其中ⅠB1期为 89.1% ,ⅠB2期为 90 .7% ,ⅡA期为 78.4 %。经单因素分析显示 ,肿瘤大小 (HR =1.4 79,P =0 .15 2 )、肿瘤局部类型 (HR =1.4 4 0 ,P =0 .2 6 4 )、临床分期(HR =1.380 ,P =0 .35 4 )、术前和 (或 )术后辅助治疗 (HR =1.2 10 ,P =0 .4 5 0 )、淋巴结转移 (HR =1.4 32 ,P =0 .5 4 0 )、颈管受侵 (HR =2 .2 4 4 ,P =0 .0 36 )、深肌层浸润 (HR =3.2 95 ,P =0 .0 6 )和多个性伴侣 +合并妊娠 (HR =10 .172 ,P =0 .0 0 0 )与早期宫颈癌预后有关。经多因素分析显示 ,宫颈深肌层浸润和多个性伴侣 +合并妊娠是影响预后的重要因素。结论 宫颈深肌层浸润和多个性伴侣
Objective To evaluate prognostic factors in patients with stage ⅠB-ⅡA of cervical carcinoma treated by surgery. Methods Between December 1992 and December 2001, 111 patients with stage ⅠB-ⅡA cervical cancer surgically treated were analyzed. Median age 40 years. According to 1994 FIGO Staging System: ⅠB 80 (ⅠB1 40,ⅠB2 40) and ⅡA 31. There were 93 cases of squamous cell carcinoma (83.5%), 17 cases of adenocarcinoma (15.3%) and one case of small cell carcinoma. All patients were treated by radical hysterectomy and pelvic lymphadenectomy, 74 patients had preoperative adjuvant radiotherapy, 24 patients had postoperative adjuvant treatment. Kaplan-Meier method was used to evaluate the survival, the related prognostic factors were assessed by Cox regression and χ 2 test. Results The overall 5- year survival rate was 85.9%, being 89.1%, 90.7% and 78.4% for stage ⅠB1, ⅠB2 and ⅡA, respectively. Univariate analysis showed that tumor size (hazards ratio =1.479, P=0.152), tumor type (HR=1.440, P=0.264), clinical stage (HR=1.380, P= 0.354), adjuvant treatment (HR=1.210, P=0.450), lymph node metastasis (HR=1.432, P=0.540 ), endocervical involvement (HR=2.244, P=0.036), depth of myometrial invasion (HR=3.295,P=0.06) and multiple sexual partners during pregnancy (HR=10.172, P=0.000) were of prognostic significance. The latter two were the most important factors indicative of poor prognosis. Conclusion The depth of myometrial invasion and multi-partners combined with pregnancy are closely related to the prognosis while the pre-and/or postoperative adjuvant therapy should be considered for stage ⅠB-ⅡA cervical cancer with deep myometrial invasion and in pregnant patients with multiple sexual partners.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2004年第8期490-492,共3页
Chinese Journal of Oncology
关键词
ⅠB期
ⅡA期
宫颈癌
预后因素
肿瘤
药物疗法
Cervical neoplasms/surgery
Cervical neoplasms/drug therapy
Prognosis
