具有盆腔淋巴结转移的宫颈癌预后影响因素研究  

Prognosis relative factors of cervical carcinoma with pelvic lymphatic metastasis

作　　者：赵映华 李孟达[2] 彭小萍[2] 薛萍萍[2] 

机构地区：[1]广东省佛山市顺德区妇幼保健院妇产科,广东佛山528300 [2]中山大学肿瘤医院妇科,广东广州510060

出　　处：《中国现代医学杂志》2007年第5期623-625,共3页China Journal of Modern Medicine

摘　　要：目的探讨具有盆腔淋巴结转移的宫颈癌病例的预后影响因素。方法对具有一侧盆腔淋巴结转移的宫颈癌手术病例157例进行回顾性分析。结果具有淋巴结转移的宫颈癌病例5年生存率为70.07%,低于宫颈癌总体5年总生存率85.3%。对不同年龄、临床类型、术前有无治疗、临床分期、肿瘤大小、病理类型以及分化程度进行单因素生存时间比较分析,其中中位生存时间高分化组18.21年、中分化组17.01年、低分化组12.22年,差异有显著性,P<0.05;其它项目各组生存时间比较差异无显著性。多因素分析生存率与组织分化显著相关,P<0.05。术后补充治疗中,化疗组中位生存时间(6.2年)明显低于放疗组(15.1年)与放化疗组(14.8年),差异有显著性,P<0.05,放化疗组与放疗组差异无显著性。结论盆腔淋巴结转移与宫颈癌病理分化程度是严重影响预后的最重要独立因素,术后补充放疗或放化疗有利于提高生存率。[Objective] To study the prognosis relative factors of uterine cervical carcinoma with pelvic lymph node metastasis. [Methods] 157 cases of cervical carcinoma with only one side of pelvic lymph node metastasis were retrospectively analyzed. [Results] The 5-year survival rate of the patients of cervical cancer with lymphatic metastasis was 70.07%, lower than the 5-year survival rate of the overall patients of cervical cancer which was 85.3% in our hospital, . In single factor compare analysis to age, clinical type, treat before surgery, stage, tumor size, histology and differentiation, the median follow-up period for well-differentiation group was 18.21 years, moderatedifferentiation was 17.01 years, poor-differentiation was 12.22 years. The differences among them were obvious （P 〈 0.05）. Other factors were not obviously different. Cox proportional hazard analysis showed, the survival rate was obviously related to tumor differentiation （P 〈0.05）. In analysis of adjuvant treatment followed surgery, the median followup period of chemotherapy group was heavily lower than that of radiotherapy and radiochemotherapy group, 6.2 to 15.1 and 14.8 years. The differences among them were obvious （P 〈0.05）. However, the median follow-up period of radiotherapy and radiochemotherapy group were not obviously different. [ Conclutions] Pelvic lymph node metastasis and tumor differentiation are the most important factors that heavily affected the prognosis of cervical cancer with lymphatic metastasis. Adjuvant radiotherapy or radiochemotherapy after operation is useful to elevate survival rate.

关 键 词：宫颈癌 淋巴结转移 预后 

分 类 号：R737.33[医药卫生—肿瘤]