摘要
目的分析化疗前免疫功能及血小板功能与局部晚期宫颈癌化疗及预后之间的关系。方法选取2010年3月至2015年3月于本院诊治且资料完整的88例局部晚期宫颈癌患者进行回顾性分析,所有患者均随访36个月,截止日期为2018年3月。根据化疗疗效不同分为有效组和无效组,根据随访结束时预后状态不同分为生存组和死亡组。采用Logistic回归和Cox风险回归模型分析局部晚期宫颈癌化疗和预后的独立危险因素。结果化疗结束后3～4周,完全缓解6例,部分缓解69例,稳定11例,进展2例;有效者75例,无效者13例;随访结束,21例患者死亡,67例生存。单因素分析显示,新辅助化疗有效和无效者在病理类型、宫颈间质浸润深度、淋巴结转移、Th/Ts及血小板计数比较差异有统计学意义(P<0.05);生存者和死亡者在FIGO临床分期、病理类型、淋巴结转移和淋巴脉管间隙浸润上差异有统计学意义(P<0.05)。多因素分析显示,病理类型、Th/Ts和血小板计数是影响局部晚期宫颈癌化疗效果的独立危险因素(P<0.05);FIGO临床分期、淋巴结转移是影响部晚期宫颈癌预后的独立危险因素(P<0.05)。结论化疗前免疫功能及血小板状态有可能成为局部晚期宫颈癌化疗的独立危险因素,但不能评估其预后。
Objective To study the correlation between chemotherapy and prognosis of locally advanced cervical cancer and immune function and platelets before chemotherapy. Methods A retrospective analysis was conducted in 88 ases of locally advanced cervical cancer from March 2010 to March 2015 in Kaizhou District People’s Hospital of Chongqing. All patients were followed up for 36 months and the deadline was Mach 2018. According to the curative effect of chemotherapy,the patients were divided into effective group and ineffective group. According to the different prognosis at the end of the follow-up,they were divided into survival group and death group. The significant factors affecting chemotherapy and prognosis of locally advanced cervical cancer were analyzed by chi square test( or T test). Then Logistic regression and Cox risk regression model were used to analyze the independent risk factors for chemotherapy and prognosis of locally advanced cervical cancer. Results 3~4 weeks after the end of chemotherapy, 6 cases were completely relieved, 69 cases were partially relieved, 11 cases were stable, 2 cases were progressed, 75 cases were effective, 13 cases were ineffective. At the end of follow-up, 21 cases died and 67 cases survived. Univariate analysis showed that the effective and ineffective of neoadjuvant chemotherapy were significantly different in pathological type, depth of cervical interstitial invasion, lymph node metastasis, Th/Ts and platelet count. There were significant differences in FIGO clinical stage, pathological type, lymph node metastasis, and lymphatic vascular infiltration between survivors and deaths(P<0.05). Multivariate analysis showed that pathological type, Th/Ts and platelet count were independent risk factors for the treatment of locally advanced cervical cancer(P<0.05). FIGO clinical stage and lymph node metastasis were independent risk factors for the prognosis of advanced cervical cancer(P<0.05). Conclusion The immune function and platelet status before chemotherapy may become an independent risk factor for chemotherapy in locally advanced cervical cancer, but the prognosis can not be assessed.
作者
赵昌芹
张瑞林
ZHAO Chang-qin;ZHANG Rui-lin(Department of Gynaecology ,Kaizhou District People's Hospital of Chongqing ,Chongqing 405400,China)
出处
《热带医学杂志》
CAS
2019年第1期76-79,共4页
Journal of Tropical Medicine
关键词
局部晚期宫颈癌
化疗
预后
免疫功能
血小板
Locally advanced cervical cancer
Chemotherapy
Prognosis
Immune function
Platelet
作者简介
赵昌芹(1987-),女,本科,主治医师,主要从事妇科肿瘤研究,E-mail:cally366@163.com.
