巨块型Ⅰb、Ⅱa期宫颈癌预后多因素COX模型分析  

Cox Regression Analysis of Factors Related to Prognosis of Bulky Stage Ⅰb、Ⅱa Cervical Cancer

作　　者：陈秋萍[1] 陈小祥[2] 彭素蓉[2] 

机构地区：[1]江苏省泗洪县中心医院妇产科,223900 [2]江苏省肿瘤医院妇瘤科,210009

出　　处：《实用癌症杂志》2008年第6期627-629,共3页The Practical Journal of Cancer

摘　　要：目的探讨影响巨块型Ⅰb、Ⅱa期宫颈癌预后的高危因素。方法回顾性分析了324例巨块型Ⅰb、Ⅱa期宫颈癌患者,Ⅰb期175例(54.0%),Ⅱa期149例(46.0%)。结果5年生存率为62.5%;单因素分析显示预后与肿块大小、临床分期、新辅助化疗、病理分级、淋巴结转移、脉管侵犯、手术切缘癌细胞残留、深肌层癌细胞浸润、宫旁癌细胞浸润关系密切(P<0.05);多因素分析显示临床分期较晚、癌细胞分化程度低、新辅助化疗、深肌层癌细胞浸润以及盆腔淋巴结转移是影响宫颈癌预后的主要危险因素(P<0.05)。结论巨块型Ⅰb、Ⅱa期宫颈癌的治疗以综合治疗方式更为有效,新辅助化疗协同后装治疗能够改善此类患者的预后。Objective To explore the prognostic factors of patients with bulky stage Ⅰb、Ⅱa cervical cancer.Methods 324 cases of bulky stage Ib、IIa cervical cancer,including 175（54.0%）FIGO stage Ⅰb2 and 149（46.0%）stage Ⅱa,were retrospectively analyzed.Results The 5-year survival rate was 62.5%.In univariate survival analysis,tumor size,clinical stage,NAC,differentiation of the carcinoma cells,the metastasis of pelvic lymph nodes,lymph vessel infiltration,surgical margin involved,deep stroma invasion and parametrial extension were related to the prognosis of cervical cancer（P〈0.05）.In COX regressive analysis,the higher risk prognostic factors were advanced clinical stage,lower grade of differentiation,NAC,deep stroma invasion and the metastasis of pelvic lymph nodes（P〈0.05）.Conclusion NAC is able to improve the prognosis of bulky stage Ⅰb、Ⅱa cervical cancer.

关 键 词：宫颈癌 新辅助化疗 COX风险比例模型 

分 类 号：R737.33[医药卫生—肿瘤]