早期宫颈鳞癌患者初次治疗后复发的影响因素分析  

An analysis of factors affecting recurrence in early cervical squamous cell carcinoma patients with recurrence after initial treatment

作　　者：吴晓莉 倪莹 王敏霞 廖海红[1] WU Xiaoli;NI Ying;WANG Minxia(Department of Gynecology,Huzhou Cent Hospital,Affiliated Cent Hospital Huzhou University,Huzhou 313000,CHINA)

机构地区：[1]浙江湖州市中心医院(湖州师范学院附属中心医院)妇科,浙江313000

出　　处：《江苏医药》2021年第7期727-731,共5页Jiangsu Medical Journal

基　　金：2019年浙江省医药卫生科技计划项目(2019RC285)。

摘　　要：目的分析早期宫颈鳞癌患者初次治疗后复发的影响因素。方法回顾性分析120例早期宫颈鳞癌患者的临床资料。120例中,34例复发(复发组),86例未复发(未复发组)。比较两组患者的相关临床资料。采用SP免疫组化法检测患者雌激素受体(ER)、孕激素受体(PR)、波形蛋白(vimentin)、p53、Ki-67和细胞角蛋白7(CK7)表达情况。采用Kaplan-Meier法计算患者生存率并绘制生存曲线,Cox回归分析早期宫颈鳞癌患者初次治疗后复发的影响因素。结果两组患者绝经情况、组织学病理分级、肿瘤大小和淋巴结微转移(LNM)情况差异有统计学意义(P<0.05)。复发组ER、PR、p53和vimentin阴性率高于未复发组,Ki-67和CK7表达阳性率高于未复发组(P<0.05)。Cox回归分析结果显示,组织学病理分级G2及G3、有LNM、Ki-67阳性和使用紫杉醇+铂类药物化疗是早期宫颈鳞癌患者初次治疗后复发的危险因素(P<0.05)。结论组织学病理分级、LNM、Ki-67和化疗方案是宫颈鳞癌患者初次治疗后复发的影响因素。Objective To analyze the factors affecting the recurrence of early cervical squamous cell carcinoma patients after initial treatment.Methods The clinical data of 120 patients with early cervical squamous cell carcinoma were retrospectively analyzed, of whom 34 cases had recurrence(group A) and 86 cases had no recurrence(group B).The clinical data were compared between the two groups.The expressions of estrogen receptor(ER),progesterone receptor(PR),vimentin, p53,Ki-67 and cell keratin 7(CK7) were detected by SP immunohistochemical method.The survival rate was calculated by Kaplan-Meier method, the survival curve was drawn, and Cox regression analysis was used to analyze the factors affecting the recurrence in early cervical squamous cell carcinoma patients after initial treatment.Results There were significant differences in menopause, histopathological grade, tumor size and microtransfer of the lymph nodes(LNM) between the two groups(P<0.05).The negative expression rates of ER,PR,p53 and vimentin in group A were significantly higher than those in group B,while the positive rates of Ki-67 and CK7 in group A were significantly higher than those in group B(P<0.05).Cox regression analysis showed that histopathological grade G2 and G3,LNM,Ki-67 positive and paclitaxel plus platinum chemotherapy were the risk factors for the recurrence of patients with early cervical squamous cell carcinoma after initial treatment(P<0.05).Conclusion Histopathological grade, LNM,Ki-67 and chemotherapy regimen are the important factors affecting the overall survival time of the patients with cervical squamous cell carcinoma after recurrence.

关 键 词：宫颈鳞癌 复发 

分 类 号：R711[医药卫生—妇产科学]