宫颈癌患者糖调节受损对改良根治术后2年内复发的影响作用  

Impact of impaired glucose regulation on recurrence within 2 years after modified radical surgery in patients with cervical cancer

作　　者：高伟聪[1] 李丽[1] 张中华 朱向辉[1] 刘素巧[1] Gao Weicong;Li Li;Zhang Zhonghua;Zhu Xianghui;Liu Suqiao(Department of Clinical Laboratory,The Second Hospital of Shijiazhuang,Shijiazhuang 050051,Hebei Province,China)

机构地区：[1]石家庄市第二医院检验科,石家庄050051

出　　处：《中华妇幼临床医学杂志（电子版）》2024年第2期231-237,共7页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：石家庄市科学技术研究与发展指导计划项目(171461463)。

摘　　要：目的探讨宫颈癌患者糖调节受损(IGR)对改良根治术后2年内复发的影响作用。方法选择2019年3月至2021年2月石家庄市第二医院住院治疗的106例初诊宫颈癌患者为研究对象,对所有患者拟进行宫颈癌改良根治术治疗。采用回顾性分析方法,以术后2年内复发时间为随访终点,根据肿瘤复发情况将患者分为复发组(n=20)和未复发组(n=86)。根据《中国2型糖尿病防治指南(2017年版)》中相关定义,评估患者IGR或糖耐量正常(NGT),前者包括空腹血糖受损(IFG)及糖耐量受损(IGT)。采用对数秩检验(Log-rank),对2组患者宫颈癌改良根治术后2年内复发风险进行比较;采用Cox比例风险回归,分析宫颈癌患者改良根治术后2年内复发的独立影响因素,并基于这些独立影响因素构建宫颈癌患者改良根治术后2年内复发的列线图预测模型。本研究经石家庄市第二医院医学伦理委员会批准(审批文号:伦审KY2019-012号)。所有患者签署临床研究知情同意书。结果①本研究106例患者中,33例被诊断为IFG,25例为IGT,IGR患者占比为54.7%;20例宫颈癌复发患者的复发时间为15.50个月。IGR患者改良根治术后2年内复发风险高于NGT患者,并且差异有统计学意义(χ^(2)=8.93,P=0.003)。②复发组国际妇产科联盟(FIGO)ⅡA期患者比例、淋巴脉管浸润(LVSI)率、肿瘤侵犯宫颈间质深1/3发生率、宫旁组织浸润阳性率、IGR患者比例,以及血清鳞癌抗原(SCC)及细胞角蛋白19片段(CYFRA21-1)水平,均高于未复发组,并且差异均有统计学意义(P<0.05)。③Cox比例风险回归分析结果显示,患者IGR(HR=4.342,95%CI:1.192~15.820,P=0.026),FIGOⅡA期(HR=3.794,95%CI:1.316~10.935,P=0.014),发生LVSI(HR=3.017,95%CI:1.137~8.007,P=0.027),血清SCC水平升高(HR=1.250,95%CI:1.015~1.538,P=0.036),血清CYFRA21-1水平升高(HR=1.217,95%CI:1.042~1.420,P=0.013),均为宫颈癌患者改良根治术后2年内复发的独立危险因素。④宫颈癌改良�Objective To explore the impact of impaired glucose regulation(IGR)on recurrence within 2 years after modified radical surgery in cervical cancer patients.Methods A total of 106 patients with newly diagnosed cervical cancer who were hospitalized in the Second Hospital of Shijiazhuang from March 2019 to February 2021 were selected as the study subjects.All patients were scheduled for modified radical surgery of cervical cancer.By retrospective analysis,the patients were divided into recurrence group(n=20)and non-recurrence group(n=86)according to the tumor recurrence within 2 years after operation.According to the definition of the Guidelines for Prevention and Treatment of Type 2 Diabetes in China(2017 Edition),patients were evaluated and divided into IGR and normal glucose tolerance(NGT).And IGR included impaired fasting glucose(IFG)and impaired glucose tolerance(IGT).Log-rank test was used to compare the risk of recurrence within 2 years after modified radical surgery of cervical cancer between two groups.Cox proportional hazard regression was used to analyze the independent influencing factors of recurrence within 2 years after modified radical hysterectomy in patients with cervical cancer,and a nomogram prediction model for recurrence within 2 years after modified radical surgery of cervical cancer patients was constructed based on these independent influencing factors.This study was approved by the Medical Ethics Committee of the Second Hospital of Shijiazhuang(Approval No.KY2019-012).All patients signed the informed consent forms for clinical research.Results①Among the 106 patients in this study,33 cases were diagnosed as IFG and 25 cases as IGT.The proportion of patients with IGR was 54.7%.The recurrence time of 20 patients with cervical cancer recurrence was 15.50 months.The risk of recurrence within 2 years after modified radical resection in patients with IGR was higher than that in patients with NGT,and the difference was statistically significant(χ^(2)=8.93,P=0.003).②The proportion of patients wi

关 键 词：宫颈肿瘤 糖调节受损 糖尿病前期 改良根治术 复发 女(雌)性 

分 类 号：R737.33[医药卫生—肿瘤]