术前血浆D-二聚体与早期宫颈癌术后复发相关性研究

发布时间：2018-02-01 03:37

  本文关键词： 宫颈癌 D-二聚体 复发 生存分析　出处：《中华肿瘤防治杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的宫颈癌FIGO分期存在一定的缺陷,血浆D-二聚体(D-D)水平与肿瘤预后密切相关。本研究探讨术前血浆D-D水平对早期宫颈癌术后复发的影响。方法试验设计属于前瞻性随访研究,以2009-01-01-2012-12-31广州市花都区妇幼保健院诊治的165例早期宫颈癌患者为研究对象。根据术前血浆D-D水平分为D-D升高组和D-D正常组,以电话随访为主,随访终点事件为宫颈癌复发。生存率估算应用Kaplan-Meier法,组间生存率曲线差异采用Log-rank检验,应用多变量Cox比例风险回归分析宫颈癌复发的独立危险因素。结果 D-D升高组67例(40.6%)。D-D正常组和D-D升高组中肿瘤直径≥4cm的比例分别为15.3%和29.9%,χ~2=5.037,P=0.025;淋巴结转移分别为35.7%和55.2%,χ~2=6.158,P=0.013;临床分期Ⅰ/ⅡA分别为47/51和20/47,χ~2=5.411,P=0.020。D-D正常组有11例复发,复发时间中位数为36(15~62)个月,5年无复发生存率为88.8%;D-D升高组有16例复发,复发时间中位数为25.5(6~50)个月,5年无复发生存率为74.0%。Kaplan-Meier生存曲线表明,D-D升高组无复发生存率显著低于D-D正常组,χ~2=4.805,P=0.028。单因素分析显示,组织学类型(HR=1.124,P=0.034)、淋巴结转移(HR=1.589,P=0.016)、FIGO分期(HR=1.854,P=0.007)、D-D水平(HR=1.395,P=0.023)和治疗方法(HR=0.891,P=0.043)为复发的危险因素。多变量Cox比例风险回归分析显示,淋巴结转移(HR=2.116,P=0.012)、FIGO分期(HR=4.421,P=0.001)、D-D水平(HR=2.125,P=0.039)和治疗方法(HR=0.912,P=0.045)是影响宫颈癌复发的独立危险因素。结论术前D-D水平是影响宫颈癌复发的危险因素,有助于更好地指导治疗、判断预后。
[Abstract]:Objective there are some defects in FIGO staging of cervical cancer. Plasma D-D level was closely related to the prognosis of cancer. This study was designed to investigate the effect of plasma D-D level on postoperative recurrence of early cervical cancer. Methods the trial design is a prospective follow-up study. A total of 165 patients with early cervical cancer diagnosed and treated by Huadu District Maternal and Child Health Hospital of Guangzhou City were selected as subjects. The plasma D-D levels were divided into D-D elevation according to preoperative plasma levels. High group and D-D normal group. The survival rate was estimated by Kaplan-Meier method and the difference of survival curve between groups was determined by Log-rank test. Multivariate Cox proportional risk regression analysis was used to analyze the independent risk factors for recurrence of cervical cancer. The proportion of tumor diameter 鈮，

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