I a1期子宫颈癌宫颈锥切术后病灶残余发生率及其相关因素  

Risk factors of predicting residual disease in women with stage I al squamous cervical carcinoma after conization

作　　者：朱新儿 冯燕[2] 傅云峰[2] 程晓东[2] 陈晓端[2] 谢幸[2] 吕卫国[2] 

机构地区：[1]浙江省富阳市妇幼保健院,311400 [2]浙江大学医学院附属妇产科医院

出　　处：《中华医学杂志》2013年第7期534-536,共3页National Medical Journal of China

基　　金：周家“十一五”支撑项目（2008BA157801）;浙江省重大科技专项计划项目（2012C13019-3）

摘　　要：目的探讨Ia1期子宫颈癌宫颈锥切术后病灶残余发生率及其相关因素。方法收集2003年1月至2007年12月浙江大学医学院附属妇产科医院收治的、并经宫颈锥形切除、组织学诊断为Ia1期子宫颈癌而接受子宫切除术83例患者的临床病理特征，并分析其与病灶残余发牛相关性。结果83例患者宫颈锥切后接受了子宫切除术，术后组织学检查结果提示有病灶残余31例，病灶残余率37．3％。31例残余病灶分别是CINI5例、CIN2～310例、微小浸润癌11例和浸润癌5例。单因素分析结果发现是否绝经、宫颈锥切的方式和锥切标本切缘状态是Ia1期子宫颈癌宫颈锥切标本病灶残余的影响因素。但Logistic回归法分析结果显示锥切标本切缘状态是Ia1期子宫颈癌宫颈锥切标本病灶残余的独立危险因素。结论Ia1期子宫颈癌宫颈锥切标本切缘状态是其病灶残余的独立危险因素，病灶近切缘和切缘阳性患者应进一步治疗。Objective To evaluate the prevalence and influencing factors of residual disease in women with stage I al squamous cervical carcinoma after conization. Methods The medical records and histopathologic slides of 83 women diagnosed with stage I al squamous cervical carcinoma after cervical conization undergoing subsequent hysterectomy at our hospital between January 2003 and December 2007 were reviewed. The correlations between the presence of residual lesions and clinicopathological features were analyzed. Results Among them, 31 （37.3%） had residual disease in hysterectomy specimens, including CIN1 （n =5） , CIN2-3 （n = 10） , microinvasive carcinoma （n = 11 ） and invasive carcinoma （n = 5）. In univariate analysis, menopause, procedure of conization, and status of cone margins were associated with the prevalence of residual disease in stage 1 al cervical carcinoma after conization. However, Logistic regression analysis revealed status of cone margins as an independent risk factor for residual disease in stage I al cervical carcinoma after conization. Conclusion Status of cone margins is an independent risk factor for residual disease in stage 1 al cervical carcinoma after conization. Further treatment should be performed in patients with positive or nearing cone margins.

关 键 词：子宫颈肿瘤 宫颈锥形切除术 子宫切除术 

分 类 号：R737.33[医药卫生—肿瘤]