2004至2019年中国部分地区子宫颈癌手术病例复发情况调查和分析  

Investigation and analysis on recurrence of cervical cancer surgery cases in some regions of China from 2004 to 2019

作　　者：陈春林[1] 刘萍[1] 李维丽[1] 曹玉叶 CHEN Chun-lin;LIU Ping;LI Wei-li;CAO Yu-ye(The Department of Obstetrics and Gynecology,Nanfang Hospital,Southern Medical University,510515 Guangzhou,China)

机构地区：[1]南方医科大学南方医院妇产科,广州510515

出　　处：《妇产与遗传（电子版）》2022年第3期1-5,共5页Obstetrics-Gynecology and Genetics (Electronic Edition)

基　　金：十二五国家科技支撑计划(2014BAI05B03);国家自然科学基金(81272585);广州市科技计划(158100075);广东省教育厅高水平大学建设经费南方医科大学临床研究启动项目(LC2016ZD019)。

摘　　要：目的调查2004至2019年中国部分地区子宫颈癌手术病例术后复发及复发子宫颈癌患者生存情况。方法基于中国子宫颈癌临床诊疗大数据项目(简称1538项目)第二期数据库,选取经手术治疗且病理、预后资料完整的病例共34086例,回顾性分析2004至2019年经手术治疗的子宫颈癌患者在不同临床病理因素下复发占比及复发时间和复发部位分布等情况。结果34086例患者中,复发病例4251例,手术病例整体复发率为12.5%。在不同临床病理情况下复发率有所不同,初诊年龄较大、期别较高的患者具有更高的复发率。肿瘤专科医院和一线城市子宫颈癌患者的复发率分别为14.6%和13.5%,高于妇幼专科医院的7.2%和二线、三线及以上城市的12.2%和12.4%。在复发时间的分析中,271例患者因复发时间不详未纳入分析,其余3890例中95.2%的患者在术后5年内复发。研究发现,发生于盆腔局部的复发占所有复发部位明确患者的41.0%,肺是最常见的远处转移部位。复发后中位随访时间20个月,总体生存率仅为54.0%,且绝大多数死亡患者死于肿瘤进展。结论不同临床病理因素下的子宫颈癌手术治疗后复发率有所不同,复发大多发生于术后5年内,且以远处复发较为多见。Objective To investigate the postoperative recurrence of cervical cancer patients and the survival of recurrent cervical cancer patients in some regions of China from 2004 to 2019.Methods Based on the second phase database of China cervical cancer clinical diagnosis and treatment big data project(1538 project for short),34086 cases with complete pathological and prognostic data after surgery were selected.The recurrence proportion,recurrence time and recurrence site distribution of cervical cancer patients treated with surgery in recent 16 years were retrospectively analyzed under different clinicopathological factors.Results Among 34086 patients,4251 cases recurred,and the overall recurrence rate of surgical cases was 12.5%.The recurrence rate varies in different clinical and pathological conditions.The older the initial diagnosis age and the higher the stage,the higher the recurrence rate.The recurrence rates of cervical cancer patients in tumor hospitals and first tier cities were 14.6%and 13.6%respectively,higher than 7.2%in women’s and children’s hospitals and 12.2%and 12.4%in second,third tier and above cities.In the analysis of recurrence time,271 patients went not included because of an unknown recurrence time,95.2%of the remaining patients relapsed within 5 years after operation.The study found that the local recurrence occurred in the pelvic cavity accounted for 41.0%of all patients with clear recurrence site,and the lung was the most common distant metastasis site.The median follow-up time after recurrence was 20 months,the overall survival rate was only 54.0%,and the vast majority of dead patients died of tumor progression.Conclusions The postoperative recurrence rate of cervical cancer is different under different clinicopathological factors.Most of the recurrence occurs within 5 years after surgery,and distant recurrence is more common.

关 键 词：宫颈肿瘤 手术病例 复发模式 

分 类 号：R737.3[医药卫生—肿瘤]