宫颈癌肺转移患者手术治疗效果及预后因素分析  

Surgical outcomes and prognostic factors of pulmonary metastasectomy for cervical cancer

作　　者：汪洋[1] 王一娜[1] 吴振华[1] 何丹[1] 范志勤[1] 

机构地区：[1]新疆医科大学附属肿瘤医院胸外科,新疆乌鲁木齐830011

出　　处：《现代肿瘤医学》2017年第15期2472-2475,共4页Journal of Modern Oncology

基　　金：新疆自治区自然科学基金项目(编号:2014211C109)

摘　　要：目的:通过对宫颈癌治疗后肺转移患者临床资料进行分析,评价外科手术治疗宫颈癌肺转移的疗效,研究影响患者生存的预后因素。方法:回顾性分析44例宫颈癌治疗后肺转移患者临床资料(手术组23例,对照组21例),采用Kaplan-Meier法进行生存分析,Log-rank检验进行单因素分析,COX风险回归模型进行多因素分析。结果:手术组1、2年生存率分别为78.2%、34.7%。手术组患者的生存曲线高于非手术组患者的生存曲线,差异有统计学意义(P<0.05),单因素分析显示,肿瘤分化程度、肺转移瘤数目、肺转移性肿瘤最大直径与患者生存率有关(P<0.05);COX比例风险回归模型分析显示,肺转移瘤数目及肺转移肿瘤最大直径是宫颈癌肺转移患者预后的独立影响因素(P<0.05)。结论:对于肺转移灶数目较少,直径较小的患者,可从肺转移灶切除中获益,积极行肺转移瘤外科治疗有助于改善宫颈癌肺转移患者的长期预后。Objective： To investigate surgical treatment outcomes and prognostic factors of the cervical cancer patients with pulmonary metastasis. Methods： The clinical data from 44 patients with lung metastases from primary cervical cancer were retrospectively reviewed. Of these 44 patients,23 received resection of lung metastases,The survival analysis was performed by Kaplan-Meier method. The Log-rank test was used for univariate analysis and the COX proportional hazards model for multivariate analysis of prognosis. Results： The 1-and 2-year survival rate of patients receiving resection of lung metastases was 78. 2% and 34. 7%. The survival difference was significant between patients with resection of lung metastases and patients without resection of lung metastases. The survival curve of patients with resection of lung metastasis is higher,respectively,uni-variate analysis showed that in patients receiving resection of lung metastases,the factors of the number of metastasis lesions,the degree of differentiation of the tumor and the maximum diameter of pulmonary metastatic tumor were significantly correlated with survival（ P〈 0. 05）,and multivariate regression analysis showed that the number of metastasis lesions and the maximum diameter of pulmonary metastatic lesion were independent prognostic factor（ P 〈0. 05）. Conclusion： We suggest that patients with lung metastases from primary cervical cancer could benefit most from aggressive surgical intervention of pulmonary metastasectomy. Its prognostic factors include smaller total number and maximum size of pulmonary metastases.

关 键 词：宫颈癌 肺转移 手术治疗 预后 

分 类 号：R730.56[医药卫生—肿瘤]