Ⅰa~Ⅲb期宫颈癌肺转移患者的临床病理特征和预后影响因素  

Clinicopathological features and prognostic factors of patients with lung metastasis of stageⅠa~Ⅲb cervical cancer

作　　者：刘红[1] 张国楠[1] 罗敏 张旭东[3] 樊英[1] 彭春蓉 Liu Hong;Zhang Guonan;Luo Min;Zhang Xudong;Fan Ying;Peng Chunrong(Departments of Gynecological Oncology,Sichuan Cancer Hospital&Institute,Cancer Hospital Affiliated to University of Electronic Science and Technology of China,Chengdu 610041,China;School of Medicine,University of Electronic Science and Technology of China,Chengdu 610054,China;GCP office,Sichuan Cancer Hospital&Institute,Cancer Hospital Affiliated to University of Electronic Science and Technology of China,Chengdu 610041,China)

机构地区：[1]四川省癌症防治中心、四川省肿瘤医院、四川省肿瘤研究所、电子科技大学附属肿瘤医院妇科肿瘤中心,成都610041 [2]电子科技大学医学院,成都610054 [3]四川省癌症防治中心、四川省肿瘤医院、四川省肿瘤研究所、电子科技大学附属肿瘤医院GCP办公室,成都610041

出　　处：《中华肿瘤杂志》2023年第4期340-347,共8页Chinese Journal of Oncology

摘　　要：目的:探讨宫颈癌患者治疗后肺转移的临床病理特征及预后影响因素。方法:回顾性分析四川省肿瘤医院2007年1月至2020年12月收治的191例Ⅰa~Ⅲb期(2009年国际妇产科联盟分期)宫颈癌肺转移患者的临床病理资料,生存分析采用Kaplan-Meier法和Log rank检验,预后影响因素分析采用Cox回归模型。结果:191例宫颈癌肺转移患者中,134例(70.2%)患者肺转移为随访检查时发现,57例(29.8%)患者有临床症状(咳嗽、胸痛、气短、咯血及发热)。全组患者从宫颈癌初始治疗到发现肺转移的时间为1~144个月,中位时间为19个月。宫颈癌肺转移后患者的2年和5年生存率分别为32.3%和17.6%。单因素分析显示,宫颈癌大小、淋巴结转移情况、宫颈癌手术后切缘阳性、宫颈癌治疗后无疾病间隔时间、是否同时伴有其他部位转移、肺转移灶数目、单侧或双侧肺转移、肺转移最大径、肺转移治疗方式与患者预后有关(均 P<0.05)。多因素分析显示,肺转移外伴随其他部位转移及肺转移数目是影响宫颈癌肺转移患者预后的独立影响因素(均 P<0.05)。 结论:宫颈癌患者随访时应重视胸部CT检查,警惕发生治疗后肺转移的可能性。肺转移外伴随其他部位转移及肺转移数目是影响宫颈癌肺转移患者预后的独立因素。对于宫颈癌治疗后肺转移的患者,手术治疗是有效的治疗方式,需严格掌握手术适应证,对于不适合肺转移病灶切除术的患者采取化疗+放疗的补救治疗措施仍是值得推荐的选择。Objective To investigate the clinicopathological features and prognostic factors of lung metastasis in patients with cervical cancer after treatment.Methods The clinicopathological data of 191 patients with lung metastasis of stageⅠa-Ⅲb cervical cancer(FIGO 2009 stage)treated in Sichuan Cancer Hospital from January 2007 to December 2020 were analyzed retrospectively.Kaplan Meier method and Log rank test were used for survival analysis,and Cox regression model was used for prognostic factors analysis.Results Among 191 patients with lung metastasis of cervical cancer,pulmonary metastasis was found in 134 patients(70.2%)during follow-up examination,and 57 patients(29.8%)had clinical symptoms(cough,chest pain,shortness of breath,hemoptysis,and fever).The time from the initial treatment of cervical cancer to the discovery of lung metastasis was 1-144 months in the whole group,with a median time of 19 months.Univariate analysis of the prognosis of lung metastasis after treatment of cervical cancer showed that the diameter of cervical tumor,lymph node metastasis,positive surgical margin,disease-free interval after treatment of cervical cancer,whether it is accompanied by other metastasis,the number,location and maximum diameter of lung metastasis,and the treatment method after lung metastasis are related to the prognosis of patients with lung metastasis of cervical cancer.Multivariate analysis showed that the number of lung metastases and other site metastases in addition to lung metastases were independent factors affecting the prognosis of patients with lung metastases of cervical cancer(P<0.05).Conclusions For patients with cervical cancer,attention should be paid to chest CT examination during follow-up to guard against the possibility of lung metastasis after treatment.Besides lung metastasis,other site metastasis and the number of lung metastasis are independent factors affecting the prognosis of patients with lung metastasis of cervical cancer.For patients with lung metastasis after treatment of cervical canc

关 键 词：宫颈肿瘤 肺转移 治疗 预后 

分 类 号：R737.33[医药卫生—肿瘤]