宫颈腺癌27例术前新辅助化疗近期疗效分析  

Short-term efficacy of neoadjuvant chemotherapy in 27 cases of cervical adenocarcinoma

作　　者：韩肖燕[1] 郄明蓉[1] 陈悦[1] 万晓丽[1] 柴青[1] 易莉莎[1] 陈莹莹[1] 

机构地区：[1]四川大学华西第二医院妇产科,成都610041

出　　处：《癌症进展》2009年第2期184-188,共5页Oncology Progress

摘　　要：目的探讨局部晚期宫颈腺癌患者实施新辅助化疗的近期疗效。方法收集我院行新辅助化疗的局部晚期宫颈腺癌患者27例,分析其化疗的近期疗效及影响因素,并与同期30例宫颈鳞癌相比较。结果27例宫颈腺癌经化疗后,16例有效,有效率为59.26%,明显低于宫颈鳞癌(83.33%),两者相比差异有统计学意义(x^2=4.079,P<0.05),其中鳞腺癌的化疗有效率仅为53.33%;宫颈腺癌的化疗效果与分化程度有关,低分化组的化疗有效率(78.57%)明显高于高-中分化组(38.46%),差异有统计学意义(x^2=4.492,P<0.05),与年龄、肿瘤直径、临床分期无关;宫颈腺癌新辅助化疗有效组术后淋巴结阳性率为18.75%(3/16),明显低于化疗无效组72.73%(8/11),差异有统计学意义(P<0.05),但未发现两组间子宫旁受累、脉管受累、深肌层浸润及手术切缘阳性率间存在差别。结论宫颈腺癌的新辅助化疗效果不及鳞癌,宫颈鳞腺癌的化疗有效率低;新辅助化疗能缩小肿瘤体积,有利于宫颈癌根治术的进行,并减少盆腔淋巴结的转移率,对于局部晚期低分化的宫颈腺癌,应积极实施新辅助化疗,有可能改善患者预后。Objective To investigate the short-term efficacy of neoadjuvant chemotherapy on cervical adenocarcinoma before operation. Methods We analyzed the short - term efficacy and the influencing factors of neoadjuvant chemotherapy in 27 patients with locally advanced cervical adenocarcinoma. The results were compared with those of 30 patients with cervical squamous carcinoma at the same time. Results The response rate of neoadjuvant chemotherapy was 59.26% in cervical adenocarcinoma, which was significantly lower than that of cervical squamous cell carcinoma （83.33%）. The effective rate in cervical adenosquamous carcinoma was only 53.33%. The short-term efficacy of neoadjuvant chemotherapy was correlated with histological grade but not with age, tumor size, and clinical stage. Poorly-differentiated cancers showed better response rate （78.57%） than well and moderately-differentiated cases （38.46%）. The positive rate of lymph node involvement in chemotherapy-responsive group was 18.75 % , which was significantly lower than that in non - responsive group （72.73 % ）. Vascular involvement, deep-muscular infiltration, parametrial involvement, and positive surgical margin were not different between two groups. Conclusions The short - term efficacy of neoadjuvant chemotherapy on cervical adenoearcinoma is poorer than that on cervical squamous cell carcinoma. Cervical adenosquamous carcinoma shows the worst response. Neoadjuvant chemotherapy before operation may decrease tumor size, benefit cervical radical surgery, and decrease lymph node metastasis.

关 键 词：宫颈癌 腺癌 新辅助化疗 疗效 

分 类 号：R737.33[医药卫生—肿瘤] R730.53[医药卫生—临床医学]