摘要
目的分析根治性手术联合或不联合辅助治疗Ⅰb2和Ⅱa2期子宫颈鳞癌患者的效果与预后影响因素。方法回顾性分析64例Ⅰb2和Ⅱa2期子宫颈鳞癌患者的病历资料,所有患者均行根治性手术治疗。按术后有无中、高危因素决定是否给予辅助治疗,统计并对比根治性手术+辅助治疗组与单纯根治性手术组的并发症、复发率。于治疗后随访3年,依据临床结局将子宫颈鳞癌患者分为生存组(n=40)与死亡组(n=24),收集患者的年龄、体重指数(BMI)等一般资料,以多因素Logistic回归分析模型分析影响Ⅰb2和Ⅱa2期子宫颈鳞癌患者预后的危险因素。结果根治性手术+辅助治疗组的并发症发生率与复发率低于单纯根治性手术组,差异有统计学意义(P<0.05);单因素分析显示:年龄、BMI、临床分期、病理分化程度、手术切缘与子宫颈鳞癌患者预后无关(P>0.05),间质浸润深度、淋巴结转移、肿瘤直径、术后是否行辅助治疗与子宫颈鳞癌患者预后有关(P<0.05);多因素Logistic回归分析模型分析显示:间质浸润深度≥1/2(β=3.070,Wald=20.999,95%CI=5.793~80.038)、有淋巴结转移(β=3.045,Wald=18.023,95%CI=5.150~85.634)、肿瘤直径>4 cm(β=2.996,Wald=19.670,95%CI=5.322~75.160)、术后未行辅助治疗(β=1.435,Wald=5.836,95%CI=1.311~13.455)是影响子宫颈鳞癌患者预后的独立危险因素(P<0.05)。结论根治性手术+辅助治疗在Ⅰb2和Ⅱa2期子宫颈鳞癌患者治疗中效果显著,并发症发生率与复发率低,而间质浸润深度≥1/2、有淋巴结转移、肿瘤直径>4 cm、术后未行辅助治疗是影响患者预后危险因素,临床需予以高度重视,并积极采取规范有效的防控措施,以改善患者预后。
Objective To analyze the efficacy and prognostic factors of radical surgery combined with or without adjuvant treatment for stageⅠb2 andⅡa2 cervical squamous cell carcinoma patients.Methods A retrospective analysis was conducted on the medical records of 64 patients with stageⅠb2 and stageⅡa2 cervical squamous cell carcinoma.All patients underwent radical surgery.Determine whether to give adjuvant treatment based on the presence or absence of medium to high-risk factors after surgery,and compared the complications and recurrence rates between the radical surgery+adjuvant treatment group and the simple radical surgery group.After treatment,patients with cervical squamous cell carcinoma were followed up for 3 years and divided into survival group(n=40)and death group(n=24)based on clinical outcomes.General data such as age and body mass index(BMI)were collected,and risk factors affecting the prognosis of cervical squamous cell carcinoma patients in stagesⅠb2 andⅡa2 were analyzed using a multivariate logistic regression analysis model.Results The incidence and recurrence rate of complications in the radical surgery+adjuvant treatment group were lower than those in the simple radical surgery group,and the difference was statistically significant(P<0.05);Univariate analysis showed that age,BMI,clinical stage,degree of pathological differentiation,surgical margin were not associated with the prognosis of cervical squamous cell carcinoma patients(P>0.05),while interstitial infiltration depth,lymph node metastasis,tumor diameter,postoperative adjuvant treatment were associated with the prognosis of cervical squamous cell carcinoma patients(P<0.05);Multivariate logistic regression analysis model analysis shows that the depth of interstitial infiltration is≥1/2(β=3.070,Wald=20.999,95%CI=5.793~80.038),with lymph node metastasis(β=3.045,Wald=18.023,95%CI=5.150~85.634),tumor diameter>4 cm(β=2.996,Wald=19.670,95%CI=5.322~75.160),without postoperative adjuvant treatment(β=1.435,Wald=5.836,95%CI=1.311~13.455)is
作者
王晓瑞
牛高丽
尹保娜
李晓丹
WANG Xiaorui;NIU Gaoli;YIN Baona(Jiaozuo Maternal and Child Health Hospital,Jiaozuo,454000)
出处
《实用癌症杂志》
2024年第4期674-677,共4页
The Practical Journal of Cancer
关键词
子宫颈鳞癌
根治性手术
辅助治疗
预后
危险因素
Cervical squamous cell carcinoma
Radical surgery
Adjuvant therapy
Prognosis
Risk factors
