宫颈残端癌31例临床病理分析  

Clinico-pathologic Analysis of Cervical Stump Cancer: A Report of 31 Cases

作　　者：张菲菲[1] 张家文[1] 郑莹[1] 王平[1] 潘小玲[1] 

机构地区：[1]四川大学华西第二医院,四川成都610041

出　　处：《实用妇产科杂志》2015年第5期361-364,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的：探讨宫颈残端癌的临床病理特点,为临床诊治及预防提供参考。方法：收集31例宫颈残端癌患者的临床病理资料并进行回顾性分析,采用PCR-反向点杂交法检测人乳头瘤病毒（HPV）,寿命表法计算生存率。结果：31例患者平均47.77±7.64岁;临床表现以阴道不规则流血为主,共16例（51.61%）;子宫次全切除原因以子宫肌瘤为主,共21例（67.74%）。入院后检测HPV阳性率83.87%（26/31）,高危型HPV阳性率77.42%（24/31）,且其中6例子宫次全切除术前与宫颈残端癌术前的高危型HPV感染情况一致。31例患者均采用手术治疗,术后补充放化疗20例。术后病理检查示原位癌累腺2例,浸润性鳞癌22例,腺癌6例,腺鳞癌1例。31例患者随访时间6-96个月,5年生存率78.20%。结论：宫颈残端癌的临床表现与一般宫颈癌相似,病理类型以鳞癌为主。HPV感染率高于正常人群。高危型HPV的检测、慎重选择子宫次全切除术以及子宫次全切除术后的严密随访对预防宫颈残端癌的发生尤为重要。Objective： To analyze the clinical and pathological characteristics of the cervical stump cancer. Methods ：Clinical and pathological data of 31 cases with cervical stump cancer were retrospectively analyzed. The survival rate was calculated using life tables method, and the infection status of HPV was examined with PCR-RDB. Results：The average age of the 31 patients was 47. 77±7. 64 years,and the common clinical manifestation was irregular vaginal bleeding（51.61% ）. Fibromyoma was the major reason for the subtotal hysterectomy（67.74% ）. The positive rate of HPV and high-risk HPV was 83.87% and 77. 42% ,respectively. All of the 31 patients received surgical treatment. Pathological examination showed 2 cases of carcinoma in situ,22 cases of invasive squamous cell carcinoma,6 cases of adenocarcinoma, and 1 case of adenosquamous carcinoma. 20 cases with high risk factors received postsurgical radiation and（or）chemotherapy. The 31 patients were followed up for 6 -96 months,and the 5-year overall survival rate was 78.20%. Conclusions：The main pathdogical type of cervical stump cancer was squamous cell carcinoma. The main pathological type of was squamous cell carcinoma. The key points to prevent cervical stump cancer included detection of the high risk factors, indication for subtotal hysterectomy, and follow-up after subtotal hysterectomy.

关 键 词：宫颈残端癌 人乳头瘤病毒感染 子宫次全切除 预防 

分 类 号：R737.33[医药卫生—肿瘤]