血清SCCA与早期宫颈鳞癌生物学行为及预后的相关性分析
发布时间：2018-07-20 09:06
【摘要】：目的:研究血清鳞状癌细胞抗原SCCA与早期宫颈鳞癌临床生物学行为的相关性并探讨其与患者3年、5年生存率及无瘤生存时间(DFS)、总生存时间(OS)的相关性,揭示术前SCCA与早期宫颈鳞癌患者临床生物学行为的关系,分析术前血清SCCA与早期宫颈鳞癌预后的关系。方法:收集2008年01月至2011年12月期间皖南医学院第一附属医院弋矶山医院收治的Ia期~IIa期宫颈鳞癌患者197例,所有患者初始治疗均为手术治疗。回顾性分析术前血清学SCCA与早期宫颈鳞癌患者年龄、临床分期、淋巴结转移、癌灶直径、宫颈肌层浸润深度、脉管浸润的相关性。随访所有患者术后血清SCCA水平,分析患者术前术后SCCA水平有无统计学差异,评估治疗效果;对比分析术后血清SCCA转阴组与未转阴组的生存情况有无差异。分别随访术前SCCA阳性组与阴性组患者3年、5年生存率、无瘤生成时间(DFS)及总生存时间(OS),分析术前SCCA情况与患者预后的关系。结果:术前SCCA表达情况与早期宫颈鳞癌患者临床分期、淋巴结转移、癌灶直径、宫颈肌层浸润深度、脉管转移等密切相关,差异有统计学意义(P0.05),而与病理组织学分级无关(P0.05),且不受年龄因素影响(P0.05)。187例患者术前血清学SCCA水平(3.29±5.71)ng/ml,术后第三月复查血清学SCCA值(1.15±1.38)ng/ml,经统计学分析,差异有统计学意义(P0.05)。术前SCCA阳性组患者49例术后SCCA下降至正常者(n=43)的总生存时间(OS)优于未降至正常者(n=6)(P0.05)。术前SCCA阴性组的无瘤生存时间及3年、5年无瘤生存率均优于术前阳性组(P0.05)。术前SCCA阴性组的3年生存率与术前阳性者相比无明显差异(P0.05);但是,随着时间的推移,术前SCCA阳性患者的生存率明显要差于阴性者(P0.05),而且术前SCCA阳性组的总生存时间(OS)也要明显差于术前阴性组。结论:血清SCCA对早期宫颈鳞癌疾病进展及严重的程度的评估有重要意义;并可以作为一种临床治疗效果的评价指标。SCCA在对早期宫颈鳞癌患者术后预后情况的预测及随访有重要意义。SCCA在早期宫颈鳞癌中阳性率并不是很高,仍不能作为早期宫颈鳞癌诊断标准,仅可作为一种辅助诊断指标。
[Abstract]:Objective: to study the correlation between serum SCCA and clinical biological behavior of early cervical squamous cell carcinoma (SCCA) and its correlation with 3-year survival rate, 5-year survival rate, tumor-free survival time (DFS) and total survival time (OS). To explore the relationship between preoperative SCCA and clinical biological behavior in patients with early cervical squamous cell carcinoma, and to analyze the relationship between preoperative serum SCCA and prognosis of early cervical squamous cell carcinoma. Methods: from January 2008 to December 2011, 197 patients with stage Ia or stage IIa cervical squamous cell carcinoma treated in the first affiliated Hospital of Southern Anhui Medical College were collected. The initial treatment of all patients was surgical treatment. The correlation between preoperative serological SCCA and age, clinical stage, lymph node metastasis, tumor focus diameter, depth of cervical myometrial infiltration and vascular infiltration in early stage of cervical squamous cell carcinoma was analyzed retrospectively. All the patients were followed up after the operation of serum SCCA level, analysis of patients before and after the SCCA level of statistical difference, evaluation of therapeutic effect, compared with the postoperative serum SCCA negative group and no negative group of survival. The 3-year, 5-year survival rate, tumor free time (DFS) and total survival time (OS) of SCCA positive group and negative group were followed up, respectively. The relationship between preoperative SCCA and prognosis was analyzed. Results: the expression of SCCA was closely related to the clinical stage, lymph node metastasis, tumor focus diameter, depth of cervical myometrial invasion and vascular metastasis in patients with early squamous cell carcinoma of the cervix. The difference was statistically significant (P0.05), but had no correlation with histopathological grade (P0.05), and was not affected by age factors (P0.05). The serum SCCA level was (3.29 卤5.71) ng / ml in 187 patients before operation, and the serum SCCA value was (1.15 卤1.38) ng / ml in the third month after operation. The difference was statistically significant (P0.05). The total survival time (OS) of 49 patients with SCCA positive before and after SCCA decreased to normal (nong43) was better than that of normal (n = 6) (P0.05). The tumor-free survival time, 3-year and 5-year tumor-free survival rate of SCCA negative group were better than those of preoperative positive group (P0.05). The 3-year survival rate in SCCA negative group was not significantly different from that in pre-SCCA positive group (P0.05); however, as time went on, The survival rate of SCCA positive patients was significantly worse than that of negative SCCA patients (P0.05), and the total survival time (OS) of SCCA positive patients was significantly worse than that of preoperative negative SCCA patients. Conclusion: serum SCCA is of great significance in evaluating the progression and severity of early squamous cell carcinoma of the cervix. SCCA has important significance in predicting and following up the postoperative prognosis of patients with early squamous cell carcinoma of the cervix. The positive rate of SCCA in early squamous cell carcinoma of the cervix is not very high. It can not be used as diagnostic criteria for early squamous cell carcinoma of the cervix and can only be used as an auxiliary diagnostic index.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33
本文编号：2133032
[Abstract]:Objective: to study the correlation between serum SCCA and clinical biological behavior of early cervical squamous cell carcinoma (SCCA) and its correlation with 3-year survival rate, 5-year survival rate, tumor-free survival time (DFS) and total survival time (OS). To explore the relationship between preoperative SCCA and clinical biological behavior in patients with early cervical squamous cell carcinoma, and to analyze the relationship between preoperative serum SCCA and prognosis of early cervical squamous cell carcinoma. Methods: from January 2008 to December 2011, 197 patients with stage Ia or stage IIa cervical squamous cell carcinoma treated in the first affiliated Hospital of Southern Anhui Medical College were collected. The initial treatment of all patients was surgical treatment. The correlation between preoperative serological SCCA and age, clinical stage, lymph node metastasis, tumor focus diameter, depth of cervical myometrial infiltration and vascular infiltration in early stage of cervical squamous cell carcinoma was analyzed retrospectively. All the patients were followed up after the operation of serum SCCA level, analysis of patients before and after the SCCA level of statistical difference, evaluation of therapeutic effect, compared with the postoperative serum SCCA negative group and no negative group of survival. The 3-year, 5-year survival rate, tumor free time (DFS) and total survival time (OS) of SCCA positive group and negative group were followed up, respectively. The relationship between preoperative SCCA and prognosis was analyzed. Results: the expression of SCCA was closely related to the clinical stage, lymph node metastasis, tumor focus diameter, depth of cervical myometrial invasion and vascular metastasis in patients with early squamous cell carcinoma of the cervix. The difference was statistically significant (P0.05), but had no correlation with histopathological grade (P0.05), and was not affected by age factors (P0.05). The serum SCCA level was (3.29 卤5.71) ng / ml in 187 patients before operation, and the serum SCCA value was (1.15 卤1.38) ng / ml in the third month after operation. The difference was statistically significant (P0.05). The total survival time (OS) of 49 patients with SCCA positive before and after SCCA decreased to normal (nong43) was better than that of normal (n = 6) (P0.05). The tumor-free survival time, 3-year and 5-year tumor-free survival rate of SCCA negative group were better than those of preoperative positive group (P0.05). The 3-year survival rate in SCCA negative group was not significantly different from that in pre-SCCA positive group (P0.05); however, as time went on, The survival rate of SCCA positive patients was significantly worse than that of negative SCCA patients (P0.05), and the total survival time (OS) of SCCA positive patients was significantly worse than that of preoperative negative SCCA patients. Conclusion: serum SCCA is of great significance in evaluating the progression and severity of early squamous cell carcinoma of the cervix. SCCA has important significance in predicting and following up the postoperative prognosis of patients with early squamous cell carcinoma of the cervix. The positive rate of SCCA in early squamous cell carcinoma of the cervix is not very high. It can not be used as diagnostic criteria for early squamous cell carcinoma of the cervix and can only be used as an auxiliary diagnostic index.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33
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