124例子宫颈浸润癌根治性子宫切除术分析  

Clinical analysis of 124 cases of invasive cervical cancer with radical hysterectomy

作　　者：马耀梅[1,2] 薛凤霞[3] 赵桂玲[2] 祁冀[2] 孙培松[2] 刘彩艳[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市中心妇产科医院妇瘤科,天津300100 [3]天津医科大学总医院妇产科,天津300052

出　　处：《天津医科大学学报》2013年第3期213-217,共5页Journal of Tianjin Medical University

摘　　要：目的：分析FIGOIa2-Ⅱa期宫颈癌患者根治性子宫切除术后结局，探讨Ia2-Ⅱa期宫颈癌的个体化治疗。方法：回顾性分析124例FIGOIa2一IIa期行根治性子宫切除术加盆腔淋巴切除术的宫颈癌患者的临床资料。结果：124例宫颈癌患者．平均年龄43．7岁，手术时间平均192min（110-285min），平均失血量553mL（200-1400mL）。29例（23．4％）患者出血超过800mL，需要输血治疗。中位随访时间为46个月，随访期内共7例患者死亡，占5．65％（7／124），6例死于宫颈癌复发，1例死于未控。124例患者5年总生存率为94．35％。单因素分析显示，年龄、病理类型、宫旁浸润与预后相关（P〈0．05）。而淋巴结转移与临床分期、宫旁浸润、脉管浸润、宫颈间质深部浸润、肿瘤大小相关（P〈0．05），与组织学分级、病理分型无关（P〉0．05）。结论：年轻患者和有宫旁浸润的患者预后较差。临床分期晚、有宫旁浸润、脉管浸润阳性、有宫颈深部间质浸润、肿瘤≥4cm是淋巴结转移的高危因素。应实施个体化综合性治疗方案，以改善患者的预后及生存质量。Objective： To investigate the individualized treatment of cervical cancer FICO Ia2-Ⅱa by analysis the outcome after radical hysterectomy. Methods： The clinical date of patients with cervical cancer FIGO stage Ia2-Ⅱa from June 2004-June 2010 were reviewed retrospectively. All patients were treated with radieal hysterectomy in Tianjin Central Obstetrics and Gynecological Hospital and with completed pathological records. They were followed up to June the 2012. Results： 124 patients, correspond to the criterion, received radi- cal hysterectomy and pelvic lymph nodes dissection. Median age was 43.7 years old. Median operating time was 192 min （range 110-285） and median blood loss was 553 mL （range 200-1 400 mL）. 29 （23.4%） patients experienced an estimated blood loss exceeding 800 mL during surgery and were transfused. Median duration of follow-up was 46 months. 7 （5.65%） patients relapsed and died. Among them, 6 patients were recurrence, 1 patient failed controlled. 5-year actuarial overall survival and disease free survival were both 94.35%. Single factor analysis manifested that significant correlation was found between the prognosis and age, para-metrial invasion and pathological type （P〈0.05） . Age, clinical stage, deep stromal invasion,tumor size, para-metrial invasion and lympho-vascular space invasion were closely related to the metastasis of lymph nodes（P〈0.05）. No significant difference was found between histologial classification and patho- logical grade （P〉0.05）. Conclusion： Age, pathologic types and para-metrial invasion are high risk factors of prognosis. Individualized comprehensive treatment plan should be taken to improve the patient＇ s prognosis and quality of life.

关 键 词：宫颈癌 浸润性 术前放化疗 盆腔淋巴结切除术 宫旁浸润 根治性子宫切除术 生存率 

分 类 号：R737.33[医药卫生—肿瘤]