早期宫颈癌根治术后肺转移的相关危险因素分析  

Risk factors analysis of lung metastasis after radical hysterectomy in early stage cervical cancer

作　　者：于红岩[1] 李楠[1] 胡新[1] YU Hongyan;LI Nan;HU Xin(Department of Gynecology,Qingdao Municipal Hospital,Qingdao 266071,Shandong,China)

机构地区：[1]青岛市市立医院妇科

出　　处：《癌症进展》2019年第13期1544-1547,共4页Oncology Progress

摘　　要：目的分析行早期宫颈癌根治术的患者术后发生肺转移的相关危险因素。方法选取296例早期宫颈癌根治术患者。根据术后是否发生肺转移,分为观察组(发生肺转移)54例和对照组(未发生肺转移)242例。统计观察组患者的临床症状及肺转移情况,比较两组患者的临床特征,采用Logistic逐步回归模型分析影响早期宫颈癌患者宫颈癌根治术后发生肺转移的独立危险因素。结果观察组54例患者中,18例患者出现咳嗽、咳痰、胸闷及胸背痛等症状;28例肺转移发生于术后第1年,16例发生于术后第2年,10例发生于术后第3年及以后;双肺转移25例,右肺转移16例,左肺转移13例;两组患者术前血清肿瘤标志物表达情况、病理类型、肿瘤直径、间质浸润深度、盆腔淋巴结转移情况、脉管瘤栓情况、宫旁或切缘阳性情况比较,差异均有统计学意义(P﹤0.05);多因素Logistic回归分析显示,肿瘤直径≥4cm、间质浸润深度﹥2/3、有盆腔淋巴结转移、宫旁或切缘阳性是早期宫颈癌患者宫颈癌根治术后发生肺转移的独立危险因素(P﹤0.05)。结论肿瘤直径≥4cm、间质浸润深度﹥2/3、有盆腔淋巴结转移、宫旁或切缘阳性的早期宫颈癌根治术患者术后更易发生肺转移。Objective To analyze the relative risk factors of lung metastasis after radical hysterectomy in patients with early stage cervical cancer. Method A total of 296 patients with early cervical cancer who underwent radical hysterectomy were selected. There were 54 patients with lung metastasis in observation group and 242 patients without lung metastasis in control group according to whether the subjects experienced lung metastasis after surgery or not. The clinical symptoms and lung metastasis of the patients in observation group were collected and the clinical characteristics of the two groups were compared. Logistic stepwise regression model was used to analyze the independent risk factors associated with lung metastasis after radical resection in patients with early cervical cancer. Result Among the 54 patients in observation group, 18 patients suffered symptoms like cough, expectoration, chest tightness and chest and back pain;28 patients experienced lung metastasis in the first year after surgery, 16 patients had metastasis in the second year after surgery, and the rest 10 patients occurred in the third year or more after surgery;25 cases suffered bilateral lung metastasis, 16 cases had right lung metastasis and 13 cases had left lung metastasis. Preoperative serum tumor markers expression, pathological type, tumor diameter, depth of interstitial infiltration, pelvic lymph node metastasis, vascular tumor thrombus, parametrial or resection margin positive were compared between the two groups and the differences were statistically significant (P<0.05);multivariate Logistic regression analysis suggested that tumor diameter ≥4 cm, depth of interstitial invasion > 2/3, pelvic lymph node metastasis, and parametrial or resection margin positive were independent risk factors for lung metastasis after radical hysterectomy of early cervical cancer (P<0.05). Conclusion Patients were more prone to suffer lung metastasis after radical hysterectomy for early cervical cancer with tumor diameter ≥ 4 cm, depth of interstiti

关 键 词：早期宫颈癌 根治术 肺转移 危险因素 

分 类 号：R737.33[医药卫生—肿瘤]