子宫颈低分化癌预后影响因素及治疗方法的探讨  

Investigation of Prognostic Factor and Treatment Mode for Undifferentiated Cervical Carcinoma

作　　者：张彦娜[1] 李孟达[1] 王骅[1] 熊樱[1] 

机构地区：[1]中山医科大学肿瘤防治中心妇科,广州510060

出　　处：《中华妇产科杂志》2000年第1期45-47,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　探讨子宫颈低分化癌预后的影响因素及治疗方法。方法　采用回顾性分析方法 ,将我院 1990年 1月至 1998年 10月收治的子宫颈低分化癌Ⅰ～Ⅱ期 14 6例 ,分为单纯手术组 (手术组 )、手术 +化学治疗 (化疗 )组、手术 +放射治疗 (放疗 )组、手术 +化疗 +放疗组 ,对各组的复发率、远处转移率和生存率进行比较。结果　子宫颈低分化癌深肌层浸润患者 ,手术 +化疗组和手术 +放疗组的复发率分别为 18.18%和 2 4 .3 2 % ,明显低于手术组的 3 6.3 6%和手术 +化疗 +放疗组的4 2 .11% (P <0 .0 5 ) ;子宫颈低分化癌淋巴结转移患者手术 +放疗组的复发率为 2 2 .2 2 % ,明显低于手术组的 2 / 2 (P <0 .0 5 )。远处转移率 ,手术 +化疗组为 0 .0 0 % ,明显低于手术组的 5 .5 6% (P <0 .0 5 ) ;3年生存率 ,以手术 +化疗组和手术 +放疗组为高 ,分别达 10 0 .0 0 %和 88.5 3 % ,与手术组的 76.74 %比较 ,差异有显著性 (P <0 .0 5 )。结论　子宫颈低分化癌的预后与淋巴结转移、临床期别及治疗方法有关 ;术后适当地给予 2个疗程化疗或局部放疗可能有助于降低局部复发率及远处转移率 ;手术 +化疗 +放疗的综合疗法并不能有效地降低复发率。Objective To analyse the prognostic factor and investigate the treatment mode for undifferentiated cervical carcinoma. Methods The recurrent rate, the metastatic rate and the survival rate were analysed retrospectively for 146 patients with stage Ⅰ～Ⅱ cervical carcinoma of poor differentiation treated with radical operation,operation/chemotherapy,operation/radiotherapy,operation/chemotherapy/radiotherapy from Jan. 1990 to Oct. 1998. Results The recurrent rate of patients treated with radical operation / chemotherapy (18.18%) or radical operation/radiotherapy (24.32%) was lower than that of patients only treated with radical operation (36.36%) or operation / chemotherapy / radiotherapy (42.11%) for the cases of stage Ⅱ or deep muscle invasion ( P <0.05). The recurrent rate of patients treated with radical operation /radiotherapy (22.22%) was lower than that of patients only treated with radical operation (2/2) for the cases with local lymphaden positive ( P <0.05). The investigation also showed that the distant metastatic rate of patients treated with radical operation/chemotherapy was 0.00%, which was lower than that of patients treated with radical operation 5.56% ( P <0.05). The 3 year survival rate was 100.00% and 88.53% respectively for the cases only treated with radical operation/chemotherapy or operation/radiotherapy; and it was lower for the cases treated with radical operation 76.74%( P <0.05). Conclusions The prognosis of undifferentiated cervical carcinoma is related to the lymph node metastasis,the International Federation of Gynecology and Obstetrics stage and the treatment methods. The local recurrent rate and distant metastasis might be reduced by 2 courses of chemotherapy or radiotherapy post operatively. The recurrent rate could not be reduced effectively by the combination therapy of operation / chemotherapy / radiotherapy.

关 键 词：子宫颈肿瘤 淋巴结转移 治疗 低分化癌 

分 类 号：R737.33[医药卫生—肿瘤] R73－37[医药卫生—临床医学]