早期宫颈癌术后阴道残端复发危险因素分析  

Analysis of risk factors for vaginal stump recurrence after early cervical cancer surgery

作　　者：张攀 吴向辉 范丽丽[1] 薛秀珍[1] ZHANG Pan;WU Xianghui;FAN Lili;XUE Xiuzhen(Department of Obstetrics,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan Province,China)

机构地区：[1]河南科技大学第一附属医院产科,河南洛阳471000

出　　处：《新乡医学院学报》2024年第11期1055-1058,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨早期宫颈癌术后阴道残端复发危险因素。方法选择2018年1月至2020年3月在河南科技大学第一附属医院接受宫颈癌根治术的243例患者为研究对象,根据术后3 a内是否发生阴道残端复发分为复发组(n=21)和未复发组(n=22)。收集2组患者的年龄、病理类型、宫颈癌国际妇产科联盟(FIGO)分期、组织分化程度、手术方式、手术切缘与肿瘤距离、肌层浸润情况、确诊时有无淋巴结受累、肿瘤出芽数、有无脉管癌栓、阴道切除长度、术后放射治疗部位等临床资料。采用单因素方差分析和二元logistic回归分析早期宫颈癌术后阴道残端复发危险因素。结果早期宫颈癌患者术后3 a内阴道残端复发率为8.64%(21/243)。复发组与未复发组患者的病理类型、手术切缘与肿瘤距离、肌层浸润情况、肿瘤出芽数、阴道切除长度和术后放射治疗部位比较差异有统计学意义(P<0.05);2组患者的年龄、FIGO分期、组织分化程度、手术方式、确诊时有无淋巴结受累、有无脉管癌栓等方面比较差异无统计学意义(P>0.05)。二元logistic回归分析结果显示,手术切缘与肿瘤距离≤3.5 mm、肿瘤出芽数>5个、阴道切除长度≤2 cm是早期宫颈癌术后阴道残端复发的危险因素(P<0.05),术后盆腔放射治疗联合阴道近距离放射治疗是早期宫颈癌术后阴道残端复发的保护性因素(P<0.05)。结论早期宫颈癌术后阴道残端复发风险较高,手术切缘与肿瘤距离≤3.5 mm、肿瘤出芽数>5个、阴道切除长度≤2 cm是早期宫颈癌术后阴道残端复发的危险因素,盆腔放射治疗联合阴道近距离放射治疗可降低早期宫颈癌术后阴道残端复发风险。Objective To explore the risk factors for vaginal stump recurrence after early cervical cancer surgery.Methods A total of 243 patients who underwent radical cervical cancer surgery in the First Affiliated Hospital of Henan University of Science and Technology from January 2018 to March 2020 were selected as the research subjects and divided into recurrence group(n=21)and non-recurrence group(n=22)based on whether vaginal stump recurrence occurred within 3 years after surgery.The clinical data of patients in the two groups,including age,pathological type,International Federation of Gynecology and Obstetrics(FIGO)staging of cervical cancer,degree of tissue differentiation,surgical approach,distance between surgical margin and tumor,muscle layer infiltration,presence or absence of lymph node involvement at diagnosis of cervical cancer,number of tumor budding,presence or absence of vascular cancer thrombus,vaginal resection length,and postoperative radiotherapy site were collected.One-way analysis of variance and binary logistic regression were used to analyze the risk factors for vaginal stump recurrence after early cervical cancer surgery.Results The recurrence rate of vaginal stumps within 3 years after early cervical cancer surgery was 8.64%(21/243).There were statistically significant differences in the pathological types,distance between surgical margin and tumor,muscle layer infiltration,number of tumor budding,vaginal resection length,and postoperative radiotherapy site of patients between the recurrence group and non-recurrence group(P<0.05);there was no statistically significant difference in the age,FIGO stage,degree of tissue differentiation,surgical approach,presence or absence of lymph node involvement at diagnosis of cervical cancer,presence or absence of vascular cancer thrombus of patients between the two groups(P>0.05).The binary logistic regression analysis showed that the distance between the surgical margin and the tumor≤3.5 mm,the number of tumor budding>5,and the vaginal resection length≤2

关 键 词：早期宫颈癌 宫颈癌根治术 阴道残端复发 危险因素 

分 类 号：R737.33[医药卫生—肿瘤]