Ⅰ期外阴癌复发的影响因素分析  

Influencing factors of recurrence of patients with stage Ⅰ vulvar cancer

作　　者：胡鹏 曾蓉[1] 张慧峰[1] Hu Peng;Zeng Rong;Zhang Huifeng(Department of Gynecological Oncology,Hubei Cancer Hospital,Wuhan 430070,China)

机构地区：[1]湖北省肿瘤医院妇瘤科

出　　处：《新医学》2019年第12期924-927,共4页Journal of New Medicine

摘　　要：目的探讨Ⅰ期外阴癌复发的影响因素。方法收集51例Ⅰ期外阴癌患者的病历资料,其中ⅠA期12例、ⅠB期39例。通过随访了解患者的复发及生存情况,根据手术治疗结束半年后是否出现临床、病理复发将患者分为未复发组和复发组,归纳2组患者的临床病理特征,应用Cox回归分析Ⅰ期外阴癌复发的影响因素。结果51例Ⅰ期外阴癌患者中有20例复发,共3例死亡(1例ⅠA期,2例ⅠB期)。单因素Cox回归分析提示组织学分级、治疗方式、切缘、浸润深度是Ⅰ期外阴癌复发的相关因素(P均<0.05),而绝经、肿瘤位置、病理类型、临床分期、肿瘤最大直径与其复发无关(P均>0.05)。多因素Cox回归分析提示组织学分级为低分化、切缘阳性、浸润深度>5 mm是Ⅰ期外阴癌复发的影响因素(P均<0.05)。结论Ⅰ期外阴癌患者手术治疗后,对于病理结果提示组织学分级为低分化、切缘阳性、浸润深度>5 mm者,需密切随访,若有复发征象,应采取积极的干预措施。Objective To investigate the influencing factors of the recurrence of patients with grade I vulvar cancer.Methods Clinical data of 51 patients with stageⅠvulvar cancer were collected including 12 cases of stageⅠA and 39 cases of stageⅠB.According to the clinical or pathological recurrence at postoperative 6 months,all patients were divided into the non-recurrence and recurrence groups.Clinical characteristics and clinicopathological data were analysed in two groups.The influencing factors of the recurrence of stageⅠvulvar cancer were further analyzed by Cox regression analysis.Results Among 51 cases,20 patients recurred and 3 cases died(1 case of stageⅠA and 2 cases of stageⅠB).Univariate Cox regression analysis demonstrated that histological classification,therapeutic method,incisional margin,depth of invasion were the influencing factors of the recurrence of stageⅠvulvar cancer(all P<0.05).Nevertheless,menopause,tumor site,pathological type,clinical staging and maximal tumor diameter were not significantly correlated with the recurrence of vulvar cancer(all P>0.05).Multivariate Cox regression analysis prompted that low-grade differentiation,positive incisional margin and depth of invasion>5 mm were the influencing factors of the recurrence of stageⅠvulvar cancer(all P<0.05).Conclusions Postoperatively,patients with low-grade differentiation,positive incisional margin and depth of invasion>5 mm should be intimately followed up.Preventive measures should be actively taken if any recurrent signs occur.

关 键 词：外阴癌 复发 组织学分级 切缘 浸润深度 

分 类 号：R73[医药卫生—肿瘤]