宫颈腺癌与鳞状细胞癌治疗反应性及预后的回顾性对比分析  

A Retrospective Comparative Analysis of Therapeutic Response and Prognosis Between Adenocarcinoma and Squamous Cell Carcinoma of Uterine Cervix

作　　者：余雪琛[1] 陈慧君[1] 蔡红兵[1] 任亮[1] 陈哲[1] 张元珍[1] 

机构地区：[1]武汉大学中南医院妇产科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2014年第3期390-394,共5页Medical Journal of Wuhan University

基　　金：国家自然基金青年基金资助项目(编号:81202071)

摘　　要：目的:比较宫颈腺癌(AC)与鳞状细胞癌(SCC)在治疗反应性及预后方面的差异。方法:回顾分析1998-2006年间武汉大学中南医院收治的ⅠA2-ⅡA2期并行根治性手术的宫颈癌患者292例,比较AC与SCC患者的临床病理特点、治疗反应性及预后。结果:AC较SCC患者确诊时分期晚且更易发生浸润转移(P<0.05)。与SCC相比AC患者的复发率高、生存时间短(P<0.05),且独立预后因素各异。AC对术前、术后辅助治疗的反应性均较SCC差(均P<0.05)。与术后辅助单纯放疗(RT)相比,同步放化疗(CRRT)可显著延长高危AC患者的无瘤生存时间(P=0.002)。结论:AC在生物学行为上与SCC不同,在治疗反应性及预后上较后者差,应针对其特点制定新的治疗策略,而术后CRRT可能有助于改善高危AC的预后。Objective： To compare the clinicopathological characteristics, therapeutic response and prog- nosis between adenocarcinoma （AC） and squamous cell carcinoma （SCC） of the uterine cervix. Methods： Records of 292 patients with FIGO stage I A2-II A2 cervical cancer, who were treated by radical surgery from 1998 to 2006 in Zhongnan Hospital of Wuhan University were reviewed retrospectively. Clinicopathological characteristics, therapeutic response and prognosis between different histology types were compared and analyzed. Results. Patients with AC showed more advanced stage and higher invasive as well as metastatic rates than those with SCC （P〈0.05, re- spectively）. AC patients demonstrated poorer response to both pre- and post-operative adjuvant therapy as compared to SCC patients （P〈0.05）. In prognostic analysis, patients with AC had higher recurrence rate and shorter tumor-free survival than those with SCC （P〈0. 05）. Besides, AC group showed different independent prognostic predictors from SCC group by Cox hazard analysis. For AC patients with high pathologic risk, those received postoperative concurrent che- moradiotherapy （CCRT） revealed significant prolonged tumor-free survival than those treated by traditional postoperative radiotherapy （RT） （P= 0. 002）. Conclusion. Compared to SCC, AC demonstrated different biologic behaviors, poorer therapeutic response, and worse prognosis. Novel treatment strategies aimed at AC should be designed. Post-operative CCRT might be useful in improving the outcome of AC.

关 键 词：宫颈腺癌 宫颈鳞癌 治疗反应性 预后 

分 类 号：R737.33[医药卫生—肿瘤]