影响宫颈癌手术治疗疗效的临床病理因素分析  

Analysis of the clinical pathological factors affecting the curative effect of carcinoma of cervix

作　　者：叶元[1] 尹茳平[1] 李力[2] 王芙霞[1] 王一兵[1] 杨冰[1] 

机构地区：[1]桂林医学院附属医院妇科,广西桂林541001 [2]广西医科大学附属肿瘤医院妇瘤科,广西南宁530021

出　　处：《华夏医学》2011年第1期10-15,共6页Acta Medicinae Sinica

摘　　要：目的:探讨影响宫颈癌手术治疗疗效的临床病理因素,为临床干预方案的合理决策提供依据。方法:选择经手术治疗、有病理诊断、病历资料及随访资料完整的宫颈癌患者424例进行回顾性研究。生存率统计采用life-table计算方法,预后相关因素分析采用COX比例风险模型和Log-rank检验。结果:单因素分析显示肿瘤分化程度、临床分期、转移复发、盆腔淋巴结阳性、术后放疗、术后化疗是影响宫颈癌手术治疗疗效的临床病理因素(P=0.000);多因素COX模型分析显示:肿瘤分化程度、临床分期、转移复发、盆腔淋巴结阳性、术后放疗是决定预后的独立因素。结论:肿瘤分化程度、临床分期、转移复发、盆腔淋巴结阳性是影响宫颈癌手术治疗疗效的重要因素,要重视宫颈癌的普查普治,做到早诊断早治疗;术中彻底清除淋巴结及加强术后辅助治疗可改善预后。Objective：To explore the clinical pathological factors affecting the curative effect of carcinoma of cervix,to provide the basis for the resonable decision-making of the clinical surgery.Methods： 424 patients with carcinoma of cervix,received surgeries were retrospective studied of their complete pathological diagnosis,medical records and follow-up data.The survival rates were calculated with life-table method,and the relevant prognostic factors were analyzed with COX risk model and log- rank inspection.Results：Single factor analysis showed that the differentiated level of tumor,clinical stages,transferring and relapse of the disease,the lymph node positive of the pelvic cavity,and radiotherapy and chemotherapy after surgery were the clinical pathological factors affecting the curative effect of the surgery of carcinoma of cervix（P= 0.000）;while the multi-factors cox model analyses showed that they are the independent factors to determine the prognosis. Conclusions：Differentiated level of tumor,clinical stages,transferring and relapse of the disease, the the lymph node positive of the pelvic cavity,and radiotherapy and chemotherapy after surgery are the important factors to inflence the curative effect of carcinoma of cervix,so importance should be attached to the examination and treatment of carcinoma of cervix so as to receive immediate diagnosis and treatment.The eradication of the lymph nodes and strengthening the postoperative adjuvant therapy can improve the prognosis.

关 键 词：宫颈癌 手术治疗 临床分期 淋巴结阳性 辅助治疗 

分 类 号：R737.33[医药卫生—肿瘤]