63例宫颈腺癌临床治疗和预后分析  

Clinical Therapy and Prognostic Analysis of Sixty-three Cases of Cervical Carcinoma

作　　者：周雷[1] 王耕辛[1] 曹文枫[2] 张连郁[2] 

机构地区：[1]天津医科大学附属肿瘤医院盆腔科,天津市300060 [2]天津医科大学附属肿瘤医院病理科,天津市300060

出　　处：《中国肿瘤临床》2004年第13期755-757,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:了解影响宫颈腺癌预后的相关因素,探讨宫颈腺癌比较理想的治疗方法。方法:对天津医科大学附属肿瘤医院1980年1月至2000年1月间收治的63例宫颈腺癌进行分析,占同期宫颈癌的4.65%,并随机选取同期治疗的80例宫颈鳞癌作为对照进行比较。患者平均发病年龄53.7岁,绝经后患者占55.6%。主要症状为阴道不规则出血和/或白带增多。其中Ⅰ期17例,Ⅱ期33例,Ⅲ期13例。20例采用单纯放射治疗,43例采用放射治疗与手术相结合的综合治疗。结果:收治的宫颈腺癌占宫颈癌的比例从80年代的3.5%(38/1087)上升至90年代的7.36%(34/462),其5年总的生存率为56.9%(33/63-5),低于同期宫颈鳞癌5年生存率。单纯放疗组5年生存率50%;手术放疗组5年生存率为60.5%,两组间无统计学差异。行根治性手术的Ⅰ、Ⅱ期患者5年生存率为80%,而行全宫切除的同期患者5年生存率仅为39.3%,但二者差异尚无统计学意义。宫颈肿瘤≥4cm和<4cm者5年生存率分别为34.3%(12/35)和60.7%(17/28)具有明显差异(P<0.05〉。Ⅰ、Ⅱ期5年生存率62%(31/50),而Ⅲ期5年生存率为7.7%(1/13),二者差异显著(P<0.01)。结论:宫颈腺癌的发病比例呈上升趋势,宫颈腺癌的预后与临床分期、肿瘤大小、治疗方式关系密切。以根治性手术为主的综合治疗是宫颈腺癌的主要治疗方法。Objective: To investigate the prognostic factors of cervical adenocarcinoma. Methods: Sixty-three cases of cervical adenocarcinoma in Tianjin Cancer Hospital from January 1980 to January 2000 were analyzed retrospectively, including 17 patients of stage, 33 stage and 13 stage. Twenty cases were given radiotherapy and 43 patients were administered for surgery and radiothery. Most of the patients with stage Ⅰ+Ⅱ were treated by radical hysterectomy and pelvic lymphadenectomy, preoperative radiotherapy was given for some patients. Results: The percentage of cervical adenocarcinoma increased from 3.5% to 7.36% in last two decades. Overall 5 year survival rate was 56.9%(33/63-5), while 5-year survival rate of stage, and was 82.3%, 54.5% and 7.7%, respectively(P<0.05). The 5-year survival rate for cervical lersion≥4cm, <4cm and with or without hysterectomy was 34.3% versus 60.7%(P<0.05) and 80% versus 39.3%(P>05). Conculsions: There is an increasing prevalence of invasive cervical adenocarcinoma. The prognostic factors of cervical adenocarcinoma were stage and bulky disease. Multidisciplinary treatments including radical surgery are the mainstay of treatment for cervical adenocarcinoma.

关 键 词：宫颈腺癌 宫颈癌根治术 放射治疗 

分 类 号：R737.33[医药卫生—肿瘤]