237例宫颈腺癌及腺鳞癌患者临床特征及预后分析  

Clinical features and prognosis of cervical adenocarcinoma and adenosquamous carcinoma: an analysis of 237 cases

作　　者：陈倩[1] 刘露 张静静[1] 韩赛[1] 崔保霞[1] 张友忠[1] 孔北华[1] CHEN Qian;LIU Lu;ZHANG Jingjing;HAN Sai;CUI Baoxia;ZHANG Youzhong;KONG Beihua(Department of Obstetrics and Gynecology,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院妇产科,山东济南250012

出　　处：《浙江大学学报（医学版）》2018年第4期357-361,共5页Journal of Zhejiang University(Medical Sciences)

基　　金：国家重点研发计划(2016YFC1302900);国家自然科学基金(81572559);山东省重点研究计划(2017CXGC1210);山东省科学技术发展计划(2014GGH218029)

摘　　要：目的:探讨宫颈腺癌和宫颈腺鳞癌患者的临床特征和预后差异。方法:回顾性分析2007年9月至2016年9月因ⅠB1～ⅡA期宫颈腺癌(201例)或宫颈腺鳞癌(36例)在山东大学齐鲁医院手术治疗患者的临床资料。比较两组的临床特征,并采用Kaplan-Meier生存曲线对两种组织学类型宫颈癌的预后进行评价。结果:宫颈腺鳞癌组淋巴血管浸润比例较宫颈腺癌组高(P <0. 01),而在年龄、FIGO分期、肿瘤直径、间质浸润深度、宫旁浸润、淋巴结转移和危险分级方面两组差异均无统计学意义(均P>0. 05)。宫颈腺癌组和宫颈腺鳞癌组患者5年总存活率分别为79. 4%和78. 3%,5年无复发存活率分别为77. 4%和73. 0%,组间差异均无统计学意义(均P> 0. 05)。术后接受同步放射治疗和化疗的患者中,5年总存活率分别为71. 0%和61. 4%,5年无复发存活率分别为68. 8%和61. 1%,组间差异均无统计学意义(均P> 0. 05)。结论:宫颈腺鳞癌较宫颈腺癌更易发生淋巴血管浸润,但两者的预后相似。Objective: To analyze the clinical features and prognosis of cervical adenocarcinoma( AC) and adenosquamous carcinoma of cervix( ASC). Methods: The clinical data of 237 patients,including 201 cases of AC and 36 cases of ASC( FIGO stage Ⅰ B1-Ⅱ A),who underwent surgery in Qilu Hospital between September 2007 and September 2016 were reviewed. Clinical features of two groups were compared,and Kaplan-Meier survival analysis was performed to evaluate the prognosis. Results: A larger proportion of ASC patients had lymphovascular space invasion compared with AC patients( P < 0. 01),but no significant differences were observed in the age,FIGO stage,size of tumor, depth of stromal invasion, parametrial invasion, lymphatic metastasis and risk grade between two groups( all P > 0. 05). The 5-year overall survival rates of AC and ASC groups were 79. 4% and 78. 3%,and the 5-year recurrence-free survival rates were 77. 4% and 73. 0%. Among patients received concurrent chemoradiotherapy,the 5-year overall survival rates were 71. 0% and 61. 4%,and the 5-year recurrence-free survival rates were 68. 8% abd 61. 1%,respectively.No significant differences were observed in 5-year overall survival rates and recurrencefree survival rates between AC and ASC patients( all P > 0. 05). Conclusion:Lymphovascular space invasion was more likely to occur in patients with ASC,but there was no significant difference in the prognosis between AC and ASC patients.

关 键 词：宫颈肿瘤/病理学 癌 鳞状细胞/病理学 腺癌/病理学 肿瘤浸润 淋巴转移 存活率 预后 

分 类 号：R737.33[医药卫生—肿瘤]