子宫颈小细胞癌的临床病理特征和预后分析  

Analyses of prognosis and clinicopathologic feature in small cell carcinoma of the cervix

作　　者：张军[1] 刘璐斌 赵喜娃[1] 李月红[2] 

机构地区：[1]河北医科大学第四医院妇科,石家庄050011 [2]河北医科大学第二医院病理科,石家庄050000

出　　处：《临床与实验病理学杂志》2016年第3期278-282,286,共6页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨子宫颈小细胞癌的临床病理特征和影响预后的因素。方法回顾性对比分析18例早期子宫颈小细胞癌和40例鳞状细胞癌的临床病理特征,采用Kaplan-Meier法分析子宫颈小细胞癌的3年总生存率及临床病理特征对生存率的影响,采用Cox回归模型明确独立的预后因素。结果 18例子宫颈小细胞癌中位年龄39岁,40例鳞状细胞癌中位年龄47岁,小细胞癌患者的中位年龄低于鳞状细胞癌(P<0.05)。早期子宫颈小细胞癌的淋巴结转移率为44.4%,脉管瘤栓发生率38.9%,复发率33.3%,均明显高于鳞状细胞癌(P<0.05)。早期子宫颈小细胞癌术后3年生存率为61.1%,鳞状细胞癌为92.5%,早期子宫颈小细胞癌的生存率明显低于鳞状细胞癌(P<0.05)。临床分期、肿块大小、淋巴结转移和脉管瘤栓是影响子宫颈小细胞癌预后的危险因素。Cox回归模型多因素分析表明以上各临床病理特征均不是独立预后因素。结论子宫颈小细胞癌与鳞状细胞癌相比,其早期易发生淋巴结转移和脉管瘤栓,易复发,预后较差。临床分期、肿块大小、淋巴结转移和脉管瘤栓是影响其预后的危险因素,但不是独立预后因素。Purpose To investigate the clinicopathologic features and prognostic factors in small cell carcinoma of the cervix. Methods A retrospective study was performed in 18 cases of early small cell carcinaoma of the cervix and 40 cases of squamous cell carcino- ma. Kaplan-Meier analysis was used to assess the impact of clinieopathologic features on 3 years survival rate. The independent prog- nostic factors of small cell cervical carcinoma were analyzed with Cox multivariate analysis. Results The median age of paiteints with small cell carcinoma is 39 year old, which singnificantly lower than that of paiteints with squamous cell carcinoma （ P 〈 0. 05 ）. In small cell cervical carcinoma, lymphatic metastasis, vascular invasion and recurrence rates were 44. 4% , 38.9% and 33.3% , respec- tively, which significantly higher than these in squamous cell carcinoma （ P 〈 0. 05 ）. Kaplan-Meier analysis results showed that the 3 years survival rate was 61.1% in small cell cervical carcinoma, which significantly lower than that in squamous cell carcinoma （P 〈 0. 05 ）. Clinical stage, lymphatic metastasis, vascular invasion and mass size were risk factors associated with poor prognosis of small cell cervical carcinoma. Cox multivariate analysis result showed that these factors were not independent prognostic factors. Conclusion Compare with squamous cell carcinoma of cervix, there is a tendency to lymphatic metastasis, vascular invasion and recurrence in early small cell carcinaoma of the cervix. Clinical stage, lymphatic metastasis, vascular invasion and mass size are not the independent prognostic factors.

关 键 词：子宫颈肿瘤 小细胞癌 临床病理特征 预后 

分 类 号：R737.33[医药卫生—肿瘤]