4374例宫颈癌患者预后及其影响因素分析  

An Analysis of the Prognostic Factors in 4374 Cases with Cervical Cancer

作　　者：王静[1,2] 许可葵 史百高 张克强[1] 周萍[1] 廖先珍 刘双喜 张怡[2] 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院,湖南长沙410013 [2]中南大学湘雅医院,湖南长沙410008 [3]湖南省肿瘤防治研究办公室,湖南长沙410013

出　　处：《中国肿瘤》2014年第4期281-288,共8页China Cancer

摘　　要：[目的]分析宫颈癌患者的生存情况及影响预后的相关因素。[方法]对1992年1月至2005年12月湖南省肿瘤医院收治的4374例宫颈癌患者进行回顾和随访,采用KaplanMeier法和Cox比例风险模型分析影响预后的相关因素。[结果 ]全组患者因宫颈癌死亡1603例。1、3、5年生存率分别为95%、85%、77%,中位生存时间175.3个月。单因素分析显示年龄、绝经情况、经产道分娩次数、病理类型、分化程度、FIGO分期、治疗方法均与预后相关。亚组分析显示,Ⅰb1期患者单纯手术生存率较高(5年生存率94%),Ⅰb2期患者基于手术的放疗(5年生存率84%)和联合化放疗生存率(5年生存率80%)较高,Ⅱ期患者手术+放疗(5年生存率75%)及根治性放疗(5年生存率75%)的生存率较高,Ⅲ期患者根治性放疗(5年生存率60%)的生存率较高。Cox回归分析显示,FIGO分期、病理类型和治疗方法是影响预后的独立因素。[结论]年龄、绝经情况、经产道分娩次数、临床分期、病理类型和治疗方法可能是宫颈癌患者预后的影响因素,但本研究因采用非随机设计,无法比较各治疗方法的优劣。[Purpose] To investigate the survival of patients with cervical cancer and analyze the prognostic factors. [ Methods ] Patients with cervical cancer （4374 cases） treated in Hunan Provincial Tumor Hospital from January 1992 to December 2005 were reviewed and followed up. Kaplan- Meier method and Cox proportional hazard model were used for statistic analysis. [Results]There were 1603 patients died of cervical cancer. The 1,3 ,and 5-year survival were 95%,85% and 77% respectively,the median survival was 175.3 months. Univariate analysis showed that survival was related to age, menopause status,times of delivery through the birth cancel,pathological types,dif- ferentiation,FIGO staging and treatment method.Patients in stage I bl treated with surgery alone had higher survival （5-years survival was 94%）;Patients in stage I b2 treated with surgery＋radiotherapy or cheomtherapy＋radiotherapy had higher survival（5-years survival was 84% and 80%）;Patients in stage II treated with surgery＋radiotherapy or palliative radiotherapy had higher survival （5- years survival all was 75%）;Patients in stage III treated with radiotherapy had higher survival（5- years survival was 60%）. [Conclusion] Age,menopause status,FIGO staging,pathological types and treatment method may be prognostic factors of patients with cervical cancer. Since the design of the study was non-randomized, the therapeutic superiority could not be well compared.

关 键 词：宫颈癌 预后 生存分析 

分 类 号：R737.33[医药卫生—肿瘤]