宫颈小细胞癌与非小细胞癌临床特征及预后的对比研究

发布时间：2018-02-24 15:02

  本文关键词： 宫颈小细胞癌 临床特征 治疗 预后 对比性研究　出处：《实用妇产科杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的:对比性研究宫颈小细胞癌(SCCC)与宫颈非小细胞癌在发病特点、临床特征、治疗方案、预后情况等方面的差异,并探究影响其预后的因素。方法:回顾性分析2003年5月至2015年6月四川大学华西第二医院收治的宫颈小细胞癌患者63例(SCCC组)和根据诊断时间及相近的FIGO分期配对的宫颈非小细胞癌(鳞癌、腺癌)患者60例(对照组)的临床病理资料及生存情况,采用Pearson卡方检验或Fisher确切概率法比较两组临床特征、治疗方案等方面的差异,Kaplan-Meier方法比较两组总体生存率及无病生存率的差异,单因素和多因素分析影响SCCC预后的因素。结果:(1)SCCC组患者初诊的中位年龄较对照组年轻(40岁vs 44岁,P=0.001),淋巴结转移率、宫旁浸润率、脉管累及率及手术切缘阳性率也均显著高于对照组(P0.05)。而在临床症状、肿块大小、诊断分期、术前治疗、术后治疗等方面比较两者差异均无统计学意义(P0.05)。(2)生存分析中,SCCC组的累积5年生存率(29.2%)与累积5年无瘤生存率(26.6%),显著低于对照组(分别为82.6%、76.7%),差异有统计学意义(P0.05)。(3)在影响SCCC预后的多因素COX多元回归分析结果显示,有淋巴结转移是影响患者5年总生存率和5年无瘤生存率的独立危险因素(HR=4.784、3.067,P0.05)。肿块直径≥4 cm是影响5年总生存率的独立危险因素(HR=3.610,P0.05)和FIGO分期(ⅠB2以上)是影响无瘤生存率的独立危险因素(HR=2.793,P0.05)。结论:SCCC患者更年轻,其临床症状、病灶外观、治疗方案等和宫颈非小细胞癌相似,但淋巴结转移率、脉管累及率、宫旁浸润率及手术切缘阳性率均显著高于宫颈非小细胞癌,预后极差。影响SCCC患者预后的主要因素为有无淋巴结转移、FIGO分期、肿块直径。
[Abstract]:Objective: to compare the differences between SCCCs and non-small cell carcinoma (NSCC) in the pathogenesis, clinical features, treatment and prognosis of cervical small cell carcinoma (SCCC), and to compare the differences between SCCCs and non-small cell carcinoma (NSCC). Methods: from May 2003 to June 2015, 63 cases of small cell carcinoma of cervix cervix treated in Huaxi second Hospital of Sichuan University were analyzed retrospectively. To non-small cell carcinoma of the cervix (squamous cell carcinoma, The clinicopathological data and survival status of 60 patients with adenocarcinoma (control group) were compared by Pearson chi-square test or Fisher exact probability method. Kaplan-Meier method was used to compare the overall survival rate and disease-free survival rate between the two groups. Results the median age, lymph node metastasis rate, para-uterine infiltration rate and the median age of patients with SCCC were 40 years younger than that of the control group, and the lymph node metastasis rate and para-uterine infiltration rate were higher than those in the control group (40 years old vs 44 years old), and the prognostic factors of SCCC were analyzed by univariate and multivariate analysis. The vascular involvement rate and the positive rate of surgical margin were significantly higher than those of the control group (P 0.05). There was no significant difference in survival analysis between the two groups in terms of postoperative treatment and survival analysis (P < 0.05). The cumulative 5-year survival rate of SCCC group was 29.22.The cumulative 5-year tumor-free survival rate of SCCC group was 26.6%, which was significantly lower than that of the control group (82.6% 76.7%, respectively). The results of multivariate COX regression analysis on the prognosis of SCCC showed that, Lymph node metastasis is an independent risk factor for 5-year overall survival and 5-year tumor-free survival in patients. Tumor diameter 鈮，

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