基于SEER数据库分析子宫体横纹肌肉瘤患者的临床特征及预后  

Analysis on clinical features and prognosis of patients with uterine corpusrhabdomyosarcoma base on SEER database

作　　者：何昊 程欣[2] 蔡红兵[1] HE Hao;CHENG Xin;CAI Hongbing(Department of Gynecological Oncology,Zhongnan Hospital of Wuhan University,Wuhan,Hubei 430062,China;Department of Gynecology,Xianning Municipal Central Hospital/First Affiliated Hospital of Hubei University of Science and Technology,Xianning,Hubei 437199,China)

机构地区：[1]武汉大学中南医院妇科肿瘤科,武汉430062 [2]咸宁市中心医院/湖北科技学院附属第一医院妇科,湖北咸宁437199

出　　处：《重庆医学》2024年第22期3367-3374,共8页Chongqing Medical Journal

基　　金：国家自然科学基金面上项目(81972447)。

摘　　要：目的探究子宫体横纹肌肉瘤(UcRMS)患者的临床病理特征、治疗方法及预后。方法从监测、流行病学和最终结果(SEER)数据库中回顾性收集2000-2020年共237例UcRMS患者的资料,采用描述性统计方法对UcRMS患者的临床病理特征及预后进行描述分析。采用Kaplan-Meier法对不同病理类型及不同治疗方法的患者进行生存分析并绘制生存曲线,生存分析比较采用log-rank检验。使用单因素和多因素Cox回归分析影响UcRMS患者预后的独立因素。结果在组织学明确的患者中最常见的类型为胚胎型[44例(18.6%)],其次为多形性[35例(14.8%)]。在治疗方面,21例(8.9%)接受了手术+化疗+放疗的治疗,75例(31.6%)接受了手术+化疗,23例(9.7%)接受了手术+放疗。队列总体中位总生存(OS)时间为13个月,中位癌症相关性生存(CSS)时间为14个月,5年OS率及5年CSS率均为16%。胚胎型RMS的OS率及CSS率明显优于未明确及其他组病理学类型,差异有统计学意义(P<0.001)。治疗方面,手术+化疗+放疗组的OS率及CSS率优于手术+化疗组及手术+放疗组,差异有统计学意义(P=0.011,P=0.012)。组织病理学类型、肿瘤分期、手术、化疗是患者OS时间和CSS时间的影响因素(P<0.05,P<0.001)。结论胚胎型UcRMS预后优于其他组织学类型,但总体预后仍然很差,5年生存率不足20%。组织学类型、分期、手术、化疗是预后的重要影响因素,手术+化疗+放疗可以改善UcRMS患者预后。Objective To investigate the clinical pathological characteristics,treatment methods and prognosis of the patients with uterine corpus rhabdomyosarcoma(UcRMS).Methods The data from 237 patients with UcRMS during 2000-2020 were retrospectively collected from the Surveillance,Epidemiology and End Results(SEER)database.The descriptive statistical method was employed to conduct the descriptive analysis on clinicopathological characteristics and prognosis of UcRMS patients.The Kaplan-Meier method was adopted to conduct the survival analysis on the patients with different pathological types and treatment methods,and draw the survival curve.The Log-rank test was employed to compare the survival analyses.The univariate and multivariate Cox regression were performed to analyze the independent factors affecting the prognosis of UcRMS patients.Results Among histologically confirmed cases,the most common type was embryonic type(44 cases,18.6%)and followed by the pleomorphic type(35 cases,14.8%).In terms of treatment,21 cases(8.9%)received the surgery combined with chemotherapy and radi otherapy(surgery+chemotherapy+radiotherapy),75 cases(31.6%)received the surgery+chemotherapy,and 23 cases(9.7%)received the surgery+radiotherapy.The median overall survival(OS)time in the cohorts was 13 months,the median cancer-related survival(CSS)was 14 months,the 5-year OS rate and CSS rate were only 16%.The OS rate and CSS rate for embryonic type RMS were significantly better than those for the undefined and other pathological types,with statistically significant differences(P<0.001).In terms of treatment,the OS rate and CSS rate in the surgery+chemotherapy+radiotherapy group were superior to those in the surgery+chemotherapy group and surgery+radiotherapy group,with statistically significant differences(P=0.011,P=0.012).The histological type,stage,surgery and chemotherapy were the factors affecting the OS time and CSS time of the patients(P<0.05,P<0.001).Conclusion The prognosis of embryonic type UcRMS is better than that of other histolo

关 键 词：横纹肌肉瘤 子宫体横纹肌肉瘤 预后 SEER数据库 

分 类 号：R737.33[医药卫生—肿瘤]