早期宫颈癌患者手术前血浆D-二聚体水平影响术后复发  

Preoperative plasma D-dimer level involved in postoperative recurrence in patients with early-stage cervical cancer

作　　者：朱海生[1] 王仁生[2] 严浩林[1] 丘春东[3] 林展[1] 梁雷锋[1] 鲁意 李玮 陈聪 

机构地区：[1]玉林市第一人民医院肿瘤科,广西壮族自治区玉林537000 [2]广西医科大学第一附属医院放疗科,广西壮族自治区南宁530021 [3]玉林市第一人民医院妇科,广西壮族自治区玉林537000 [4]温州市人民医院妇科,浙江温州325000

出　　处：《肿瘤》2016年第11期1254-1259,1279,共7页Tumor

摘　　要：目的 :探讨手术前血浆D-二聚体(D-dimer,D-D)水平对早期宫颈癌患者手术后复发的影响。方法 :这是个前瞻性研究。对2009年1月1日—2012年12月31日在温州市人民医院进行宫颈癌根治术的165患者进行随访,以宫颈癌复发为终点事件。根据手术前血浆D-D水平分为D-D≥0.50 mg/L组(67例,40.6%)和D-D<0.50 mg/L组(98例,59.4%),Kaplan-Meier法绘制患者的生存曲线,分析影响宫颈癌复发的危险因素。结果 :D-D<0.50 mg/L组有11例患者复发,中位复发时间为36个月,5年无复发生存率为88.8%(87/98);D-D≥0.50 mg/L组有16例患者复发,中位复发时间为25.5个月,5年无复发生存率为76.1%(51/67)。D-D≥0.50mg/L组患者的无复发生存率显著低于<0.50 mg/L组(P=0.028)。淋巴结转移、宫颈癌国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)分期、血浆D-D水平和治疗方法是影响宫颈癌复发的独立危险因素(P值均<0.05)。结论 :手术前血浆D-D水平是影响宫颈癌复发的危险因素。Objective： To investigate the effect of preoperative plasma D-dimer （D-D） level on the recurrence of patients with early-stage cervical cancerMethods： This prospective study included 165 patients with cervical cancer who received radical resection in Wenzhou People＇s Hospital between January 1, 2009 and December endpoint of follow-up was cancer 31, 2009 and were followed-up. The recurrence. These patients were divided into D-D ≥ 0.50 mg/L group （n = 67, 40.6%） and D-D to preoperative plasma D-D level. The survival curve 〈 0.50 mg/L group （n = 98, 59.4%） according of these patients was estimated by Kaplan- Meier method. The risk factors related to the recurrence of cervical cancer were analyzed Results： In D-D 〈 0.50 mg/L group, 11 patients had cancer recurrence with a median recurrent time of 36 months and 5-year recurrence-free survival rate of 88.8% （87/98）. In D-D ≥0.50 mg/L group, 16 patients had cancer recurrence with a median recurrent time of 25.5 months and 5-year recurrence-free survival rate of 76.1% （51/67）. The recurrence-free survival rate in D-D ≥ 0.50 mg/L group was significantly lower than that in D-D 〈 0.50 mg/L （P = 0.028）. The lymph node metastasis, International Federation of Gynecology and Obstetrics （FIGO） stage, plasma D-D level and the treatment method were independent risk factors for cervical cancer recurrence （all P 〈 0.05）.Conclusion： D-D level is an independent risk factor affecting the recurrence of cervical cancer.

关 键 词：宫颈肿瘤 复发 危险因素 D-二聚体 

分 类 号：R737.33[医药卫生—肿瘤]