宫颈癌术后患者临床预后影响的多因素分析  

Multivariate prognostic analysis of patients with cervical cancer

作　　者：姜光瑶[1] 赵志伟[2] 吴江[2] 郭鹏[2] 

机构地区：[1]四川大学华西第四医院,四川成都610041 [2]四川大学华西基础医学与法医学院,四川成都610041

出　　处：《西部医学》2015年第12期1806-1809,共4页Medical Journal of West China

基　　金：国家自然科学基金(11262020);四川省应用基础计划项目(2013JY0021)

摘　　要：目的探讨影响宫颈癌临床预后的影响因素，为宫颈癌的临床治疗和预防措施提供依据。方法纳入2010年1月-2014年1z月在我院住院手术治疗的168例宫颈癌患者的病理资料（包括年龄、肿块直径、分化程度、肿瘤分期、有无浸润或淋巴结转移、FIG0分期、HPV检测等），采用单因素方差分析及COX回归等统计方法分析影响宫颈癌临床预后的影响因素。结果①研究纳入168例患者，其中鳞癌106例（63．1％），腺癌57例（33．9％）；1年累计生存率为95．2％，3年累计生存率为62．8％，5年累计生存率为54．7％。②单因素方差分析结果显示，年龄、肿块直径、分化程度、肿瘤分期、淋巴结转移、HPV阳性6项指标呈显著相关。③COX回归分析显示，有4项指标纳入回归分析模型，其中肿块直径相对危险度为2．026（1．253，3．277），HPV阳性相对危险度为1．73（1．08，2．77）；肿瘤分期相对危险度为1．478（1．031，2．12）；分化程度显示，患者肿瘤越趋向低分化，生存率越低。结论肿块直径、肿瘤分期、HPV检测、分化程度对宫颈癌的临床预后影响较大，临床干预中需要提供相关指标的监测效能，给予患者有针对性的早期干预。Objective The aim of this study was to evaluate multivariate prognostic factors influencing the clinical prognosis of patients with cervical cancer. Methods 168 patients with cervical cancer treated in our hospital between Jan- uary 2010 and December 2014 were reviewed and analyzed. There age, tumor size, tumor differentiation, lymph node status, FIGO staging and HPV examination were analyzed by COX regression analyses. Results Among 168 patients, there were 106 patients with squamous carcinoma （63.1%, 57 with adenocarcinoma （33.9%）. The accumulative sur- vival rate was 95.2% within 1 year, 62.8% within 3 years, and 54. 7%within 5 years. Age, slump diameter, differenti- ation degree, tumor staging, lymphatic metastasis and HPV positive were found to be independently related to patients＇ poor survival based on univariate analyses. Cox regression analysis showed the relative risk degree of slump tumor was 2. 026 （1. 253, 3. 277）. The relative risk degree of HPV positive was 1.73 （1.08, 2.77） and that of the tumor staging was 1. 478 （1. 031, 2.12）. And the differentiation degree reflected that the lower the differentiation was, the lower the survival rate would be. Conclusion Slump diameter, tumor staging, HPV detection and differentiation degree are impor- tant clinicaI prognostic factors of cervical carcinoma. Postoperative therapy needs to be individualized according to these prognostic factors and validated for its efficacy using randomized clinical trials.

关 键 词：宫颈癌 临床预后 影响因素 生存率 COX回归 

分 类 号：R737.33[医药卫生—肿瘤]