本文關鍵詞： 宮頸癌 D-二聚體 復發(fā) 生存分析　出處：《中華腫瘤防治雜志》2017年08期 　論文類型：期刊論文

【摘要】：目的宮頸癌FIGO分期存在一定的缺陷,血漿D-二聚體(D-D)水平與腫瘤預后密切相關。本研究探討術(shù)前血漿D-D水平對早期宮頸癌術(shù)后復發(fā)的影響。方法試驗設計屬于前瞻性隨訪研究,以2009-01-01-2012-12-31廣州市花都區(qū)婦幼保健院診治的165例早期宮頸癌患者為研究對象。根據(jù)術(shù)前血漿D-D水平分為D-D升高組和D-D正常組,以電話隨訪為主,隨訪終點事件為宮頸癌復發(fā)。生存率估算應用Kaplan-Meier法,組間生存率曲線差異采用Log-rank檢驗,應用多變量Cox比例風險回歸分析宮頸癌復發(fā)的獨立危險因素。結(jié)果 D-D升高組67例(40.6%)。D-D正常組和D-D升高組中腫瘤直徑≥4cm的比例分別為15.3%和29.9%,χ~2=5.037,P=0.025;淋巴結(jié)轉(zhuǎn)移分別為35.7%和55.2%,χ~2=6.158,P=0.013;臨床分期Ⅰ/ⅡA分別為47/51和20/47,χ~2=5.411,P=0.020。D-D正常組有11例復發(fā),復發(fā)時間中位數(shù)為36(15~62)個月,5年無復發(fā)生存率為88.8%;D-D升高組有16例復發(fā),復發(fā)時間中位數(shù)為25.5(6~50)個月,5年無復發(fā)生存率為74.0%。Kaplan-Meier生存曲線表明,D-D升高組無復發(fā)生存率顯著低于D-D正常組,χ~2=4.805,P=0.028。單因素分析顯示,組織學類型(HR=1.124,P=0.034)、淋巴結(jié)轉(zhuǎn)移(HR=1.589,P=0.016)、FIGO分期(HR=1.854,P=0.007)、D-D水平(HR=1.395,P=0.023)和治療方法(HR=0.891,P=0.043)為復發(fā)的危險因素。多變量Cox比例風險回歸分析顯示,淋巴結(jié)轉(zhuǎn)移(HR=2.116,P=0.012)、FIGO分期(HR=4.421,P=0.001)、D-D水平(HR=2.125,P=0.039)和治療方法(HR=0.912,P=0.045)是影響宮頸癌復發(fā)的獨立危險因素。結(jié)論術(shù)前D-D水平是影響宮頸癌復發(fā)的危險因素,有助于更好地指導治療、判斷預后。
[Abstract]:Objective there are some defects in FIGO staging of cervical cancer. Plasma D-D level was closely related to the prognosis of cancer. This study was designed to investigate the effect of plasma D-D level on postoperative recurrence of early cervical cancer. Methods the trial design is a prospective follow-up study. A total of 165 patients with early cervical cancer diagnosed and treated by Huadu District Maternal and Child Health Hospital of Guangzhou City were selected as subjects. The plasma D-D levels were divided into D-D elevation according to preoperative plasma levels. High group and D-D normal group. The survival rate was estimated by Kaplan-Meier method and the difference of survival curve between groups was determined by Log-rank test. Multivariate Cox proportional risk regression analysis was used to analyze the independent risk factors for recurrence of cervical cancer. The proportion of tumor diameter 鈮，

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