本文關(guān)鍵詞： 子宮內(nèi)膜癌 激素輔助治療 預(yù)后 Cox模型 激素輔助治療 子宮內(nèi)膜癌 系統(tǒng)評價 隨機對照試驗 Meta分析　出處：《廣西醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的觀察激素治療對手術(shù)后的子宮內(nèi)膜癌患者預(yù)后的影響,探索激素治療的可行性。 方法本研究收集了2005年1月到2013年5月在廣西醫(yī)科大學(xué)附屬腫瘤醫(yī)院婦瘤科住院的321例高危型子宮內(nèi)膜癌患者的病歷資料,進行回顧性研究。統(tǒng)計學(xué)處理：應(yīng)用SPSS.19.0軟件進行統(tǒng)計學(xué)分析,對計數(shù)資料及率的比較采用X2檢驗,對子宮內(nèi)膜癌術(shù)后激素治療療效的影響因素采用Kaplan-meier生存分析進行單因素分析,Log-rank test檢驗,P0.05表示差異有統(tǒng)計學(xué)意義,對有意義的單因素進行Cox模型多因素分析,多因素分析P0.05認(rèn)為差異具有統(tǒng)計學(xué)意義。 結(jié)果影響激素治療療效的因素分析：激素使用是否超過1年、孕激素受體(PR)、病理分級、病理分期是影響激素治療療效的重要因素(P0.05),多因素分析：孕激素受體(PR)、病理分級、激素使用是否超過1年是影響激素治療療效的獨立危險因素(P0.05)。激素治療對于復(fù)發(fā)率、生存率的影響：激素組的復(fù)發(fā)率低于對照組,兩者比較差異具有顯著性(P0.05)；激素組的5年生存率較對照組高,兩者比較差異具有顯著性(P0.05)；激素組無瘤生存率比對照組高,差異具有顯著性(P0.05)。 結(jié)論激素治療作為子宮內(nèi)膜癌患者綜合治療的一部分,持續(xù)應(yīng)用1年以上,能夠改善患者的長期預(yù)后,減少復(fù)發(fā),增加患者總生存率,術(shù)后有高危因素的子宮內(nèi)膜癌可以考慮使用激素治療,以改善患者的預(yù)后。。 目的系統(tǒng)評價激素治療對早期子宮內(nèi)膜癌患者預(yù)后的影響,研究激素治療是否能改善早期高危型子宮內(nèi)膜癌患者的預(yù)后。 方法計算機檢索MEDLINE、EMbase、Cochrane圖書館、Pubmed、Ovid數(shù)據(jù)庫、中國知網(wǎng)、維普中文科技期刊數(shù)據(jù)庫、清華同方數(shù)據(jù)庫、萬方數(shù)據(jù)庫等,手工檢索與子宮內(nèi)膜癌激素治療相關(guān)的文獻,檢索截止時間2013年12月,收集子宮內(nèi)膜癌輔助使用激素治療的隨機對照試驗和臨床對照試驗。由兩名研究人員選擇獨立試驗,提取資料,評價納入資料的方法與質(zhì)量,并提取數(shù)據(jù)進行Meta分析。 結(jié)果最終納入符合條件的RCTs共6個,包括6篇文獻和4440例患者,對入選研究的治療組與對照組的總體復(fù)發(fā)率、總體生存率、無瘤生存率的比較,進行統(tǒng)計學(xué)分析與比較。Meta分析結(jié)果顯示：治療組與對照組的復(fù)發(fā)率、總生存率、無瘤生存率比較(P0.05),差異沒有統(tǒng)計學(xué)顯著性,手術(shù)+激素治療組比較單純手術(shù)組對于患者的復(fù)發(fā)率、總生存率、無瘤生存率沒有明顯影響,不能改善早期子宮內(nèi)膜癌的預(yù)后。對高危型子宮內(nèi)膜癌激素治療療效的分析,手術(shù)+激素治療組與單純手術(shù)組復(fù)發(fā)率及無瘤生存率比較有統(tǒng)計學(xué)差異(P0.05),總生存率差異沒有統(tǒng)計學(xué)意義(P0.05),手術(shù)+激素治療組復(fù)發(fā)率較單純手術(shù)組低,無瘤生存率較單純手術(shù)組高,激素治療可以改善患者的復(fù)發(fā)率及無瘤生存率,但對總生存率沒有明顯影響。 結(jié)論目前尚不能認(rèn)為術(shù)后應(yīng)用激素治療能夠改善早期子宮內(nèi)膜癌的預(yù)后。但激素治療對于改善早期高危型子宮內(nèi)膜癌的預(yù)后有一定的作用。
[Abstract]:Objective To observe the effect of hormone therapy on the prognosis of patients with endometrial carcinoma after operation, and to explore the feasibility of hormone therapy.
Methods this study collected from January 2005 to May 2013 in the Department of Gynecology Hospital Affiliated Tumor Hospital of Guangxi Medical University 321 patients with high-risk endometrial cancer clinical data were retrospectively analyzed. Statistical analysis: SPSS.19.0 software was used for statistical analysis of count data, and compared with the rate of X2 test, Kaplan-meier survival analysis was used for single factor analysis the influence factors of hormone therapy in endometrial carcinoma after operation, Log-rank test test, P0.05 said the difference was statistically significant, the single factor meaningful Cox model multivariate analysis, multivariate analysis P0.05 considered statistically significant difference.
Analysis of factors affecting the outcome of hormone therapy: hormone use is more than 1 years, progesterone receptor (PR), pathological grade, pathological stage is an important factor affecting hormone therapy (P0.05), multivariate analysis: progesterone receptor (PR), pathological grade, hormone use is more than 1 years were independent risk factors affecting hormone the curative effect of hormone therapy (P0.05). The recurrence rate, affecting the survival rate: the treatment group the recurrence rate was lower than the control group, the difference was statistically significant (P0.05); treatment group 5 years survival rate is higher than the control group, the difference was statistically significant (P0.05); group hormone free survival the rate is higher than the control group, the difference was significant (P0.05).
Conclusion hormone therapy as part of a comprehensive treatment of patients with endometrial cancer, continuous use of more than 1 years, the long-term prognosis of patients can be improved by reducing the recurrence of patients, increase the total survival rate, postoperative endometrial cancer risk factors can be considered using hormone therapy to improve the prognosis of patients.
Objective to systematically evaluate the effect of hormone therapy on the prognosis of patients with early endometrial cancer, and to study whether hormone therapy can improve the prognosis of early high-risk endometrial cancer.
Methods we searched MEDLINE, EMbase, Cochrane library, Pubmed, Ovid database, Chinese HowNet, Chinese VIP periodical database, Tsinghua Tongfang database, Wanfang database, and endometrial cancer associated with hormone therapy literature manual retrieval, retrieval deadline December 2013, randomized controlled trials and controlled clinical trials to collect endometrial cancer adjuvant use hormone therapy. By two researchers independently test, data extraction and quality assessment into data and data extraction method, Meta analysis was carried out.
緇撴灉鏈，

本文編號：1524792