宫颈残端癌31例临床病理分析

发布时间：2019-01-16 05:03

【摘要】：目的:探讨宫颈残端癌的临床病理特点,为临床诊治及预防提供参考。方法:收集31例宫颈残端癌患者的临床病理资料并进行回顾性分析,采用PCR-反向点杂交法检测人乳头瘤病毒(HPV),寿命表法计算生存率。结果:31例患者平均47.77±7.64岁;临床表现以阴道不规则流血为主,共16例(51.61%);子宫次全切除原因以子宫肌瘤为主,共21例(67.74%)。入院后检测HPV阳性率83.87%(26/31),高危型HPV阳性率77.42%(24/31),且其中6例子宫次全切除术前与宫颈残端癌术前的高危型HPV感染情况一致。31例患者均采用手术治疗,术后补充放化疗20例。术后病理检查示原位癌累腺2例,浸润性鳞癌22例,腺癌6例,腺鳞癌1例。31例患者随访时间6~96个月,5年生存率78.20%。结论:宫颈残端癌的临床表现与一般宫颈癌相似,病理类型以鳞癌为主。HPV感染率高于正常人群。高危型HPV的检测、慎重选择子宫次全切除术以及子宫次全切除术后的严密随访对预防宫颈残端癌的发生尤为重要。
[Abstract]:Objective: to investigate the clinicopathological features of cervical stump carcinoma and to provide reference for clinical diagnosis, treatment and prevention. Methods: the clinicopathological data of 31 patients with cervical stump carcinoma were collected and analyzed retrospectively. The survival rate was calculated by PCR- reverse dot hybridization and (HPV), life table method. Results: the average age of 31 patients was 47.77 卤7.64 years, the main clinical manifestations were irregular vaginal bleeding (51.61%), and the subtotal hysterectomy was mainly caused by uterine leiomyoma (21 cases, 67.74%). The positive rate of HPV was 83.87% (26 / 31) and the positive rate of high-risk HPV was 77.42% (24 / 31). The high risk HPV infection before subtotal hysterectomy in 6 cases was the same as that before cervical stump cancer. 31 cases were treated by operation and 20 cases were treated with radiotherapy and chemotherapy after operation. Pathological examination showed that there were 2 cases of carcinoma in situ, 22 cases of invasive squamous cell carcinoma, 6 cases of adenocarcinoma and 1 case of adenosquamous carcinoma. 31 cases were followed up for 6 ~ 96 months, and the 5-year survival rate was 78.20%. Conclusion: the clinical manifestation of cervical stump carcinoma is similar to that of normal cervical carcinoma, and the pathological type is squamous cell carcinoma. The infection rate of HPV is higher than that of normal population. The detection of high risk HPV, careful selection of subtotal hysterectomy and strict follow-up after subtotal hysterectomy are particularly important to prevent the occurrence of cervical stump carcinoma.
【作者单位】：四川大学华西第二医院;
【分类号】：R737.33

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