摘要
目的 分析宫颈小细胞癌（small cellcarcinoma of the cervix，SCCC）患者的临床病理特征及其预后影响因素。方法 选择我院2006年1月至2016年12月确诊的56例SCCC患者作为观察组，另选同期收治且FIGO分期配对的56例宫颈非小细胞癌患者作为对照组，对两组患者的临床病理特征及预后情况进行分析，并对SCCC预后相关因素进行分析。结果 （1）观察组初诊年龄≤40岁、有淋巴结转移、有脉管累及、有宫旁浸润、切缘阳性的比例均较对照组明显增多（P值分别为0.003、0.041、0.001、0.019、0.022）。（2）观察组患者5年无瘤生存率为25.0%、5年总生存率为28.6%，对照组分别为76.8%、82.1%，两组比较差异均有统计学意义（χ2值分别为11.698、13.241，P均〈0.05）。（3）经多因素COX多元回归分析，淋巴结转移是独立影响SCCC 5年无瘤生存率、5年总生存率的危险因素（HR值分别为3.178、4.895，P均〈0.05）；肿瘤直径≥4 cm是SCCC 5年总生存率的影响因素（HR＝3.721，P〈0.05），而FIGO分期ⅠB2~ⅡB是SCCC 5年无瘤生存率的影响因素（HR＝2.894，P〈0.05）。结论 SCCC患者较宫颈非小细胞癌患者有年轻化趋势，且淋巴结转移、脉管累及、宫旁浸润、切缘阳性的比例明显增高，预后也更差；淋巴结转移、肿瘤直径、FIGO分期可作为影响其预后的危险因素。
Objective To analyze the clinical characteristics of small cellcarcinoma of the cervix （SCCC） and explore the related prognostic factors.Methods A retrospective analysis of 56 cases of SCCC patients （observation group） diagnosed from January 2006 to December 2016 was performed, another 56 patients with non-small cellcarcinoma of the cervix with same FIGO staging were selected as the control group over the same period.The clinical characteristics, pathological data and prognosis and the prognostic factors of SCCC of the two groups were analyzed.Results （1） The rate of first visit age ≤40 years, lymph node metastasis, parametrial infiltration, vascular involvement and positive surgical margins in observation group were significantly higher than those of controI group（P=0.003, 0.041, 0.001, 0.019, 0.022）. （2） The 5-year disease-free survival rate of the observation group was 25.0%, and the 5-year overall survival rate was 28.6%, which was significantly lower than that of the control group （76.8%, 82.1%）, the differences were statistically significant（χ2=11.698, 13.241, P〈0.05）. （3） In the COX multivariate regression analysis, the results showed that the lymph node metastasis was the independent factor influencing 5-year disease-free survival rate and 5-year overall survival rate（HR=3.178、4.895, P〈0.05）. In addition, the tumor size ≥4 cm was the independent factor influencing 5-year overall survival rate（HR=3.721, P〈0.05）, and advanced FIGO staging ⅠB2-ⅡB was the independent factor influencing 5-year disease-free survival rate（HR=2.894, P〈0.05）.Conclusion The patients with SCCC are younger, and the rate of lymph node metastasis, parametrial infiltration, vascular involvement and positive surgical margins in patients with SCCC are significantly higher than non-small cell carcinoma of the cervix, and the prognosis of the patients with SCCC is very poor.The main prognostic factors were lymph node metastasis, advanced FIGO stage and tumor size.
出处
《中国综合临床》
2018年第2期165-169,共5页
Clinical Medicine of China
关键词
宫颈小细胞癌
宫颈非小细胞癌
临床特征
生存率
Small cellcarcinoma of the cervix
Non small cellcarcinoma of the cervix
Clinical characteristics
Survival rate
