【摘要】：影響陰道癌預(yù)后的臨床病理因素分析 目的：探討影響原發(fā)性陰道癌預(yù)后的臨床病理因素。方法：對(duì)1985年-2012年間廣西醫(yī)科大學(xué)附屬腫瘤醫(yī)院進(jìn)行完整治療的有病理診斷、病歷資料及隨訪的60例陰道惡性腫瘤患者進(jìn)行回顧性分析,分析年齡、絕經(jīng)與否、FIGO臨床分期、有無(wú)子宮切除史、病理類型、腫瘤大小、陰道受侵長(zhǎng)度、民族、治療方法等對(duì)患者預(yù)后的影響,使用壽命表法及Kaplan-Meier計(jì)算生存率,差異性經(jīng)Log-rank test進(jìn)行檢驗(yàn),并用COX模型進(jìn)行多因素的分析。結(jié)果：?jiǎn)我蛩厣娣治鼋Y(jié)果顯示,鱗癌患者的預(yù)后比非鱗癌患者的預(yù)后要好,并且FIGO臨床分期越晚,陰道受侵長(zhǎng)度越長(zhǎng),患者的預(yù)后就越差,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。多因素分析結(jié)果顯示,FIGO臨床分期、病理類型是影響陰道癌預(yù)后的主要危險(xiǎn)因素。結(jié)論：影響陰道癌預(yù)后的臨床病理因素主要有FIGO臨床分期、病理類型,陰道受侵長(zhǎng)度越長(zhǎng),患者的預(yù)后就越差。 放療及手術(shù)在陰道癌治療價(jià)值的Meta分析 目的：評(píng)價(jià)放療及手術(shù)在陰道癌治療中的價(jià)值。方法：檢索中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)、中國(guó)知網(wǎng)、Pubmed。篩選符合納入標(biāo)準(zhǔn)的2003年1月1日至2013年10月30日公開發(fā)表的評(píng)價(jià)了放療(±化療)、手術(shù)(±化療)、放療+手術(shù)(±化療)等治療方法對(duì)于陰道癌預(yù)后影響的國(guó)內(nèi)外論文,以生存率為觀察指標(biāo),原始文獻(xiàn)中有明確的隨訪截尾數(shù)據(jù)。對(duì)各研究間的異質(zhì)性及對(duì)提取的各個(gè)效應(yīng)量用統(tǒng)計(jì)軟件STATAl1.0進(jìn)行合并與統(tǒng)計(jì)推斷。結(jié)果：納入的4個(gè)研究中,手術(shù)、放療、手術(shù)+放療之間的5年生存率差異并無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論：Meta分析的結(jié)果顯示不同的治療方法之間的5年生存率差異并無(wú)統(tǒng)計(jì)學(xué)意義,陰道癌的治療需綜合患者的一般情況、臨床分期、病理類型、癌灶部位等因素,在盡可能安全及減少治療后并發(fā)癥的前提下,采用單純手術(shù)、單純放療或手術(shù)+放療等治療方案,并輔以化療改善預(yù)后。
[Abstract]:Analysis of clinicopathological factors influencing the prognosis of vaginal carcinoma objective: to explore the clinicopathological factors affecting the prognosis of primary vaginal carcinoma. Methods: from 1985 to 2012, 60 patients with vagina malignant tumor who underwent complete treatment in the affiliated Cancer Hospital of Guangxi Medical University were retrospectively analyzed. The age, menopausal stage and Figo clinical stage were analyzed. The influence of history of hysterectomy, pathological type, tumor size, length of vagina invasion, nationality, treatment methods on the prognosis of the patients. The survival rate was calculated by using life table method and Kaplan-Meier. The difference was tested by Log-rank test. COX model was used to analyze multiple factors. Results: the results of univariate survival analysis showed that the prognosis of patients with squamous cell carcinoma was better than that of patients with non-squamous cell carcinoma, and the later the clinical stage of FIGO was, the longer the length of vagina invasion was, the worse the prognosis of patients was (P0.05). Multivariate analysis showed that Figo staging and pathological type were the main risk factors for the prognosis of vaginal carcinoma. Conclusion: the main clinicopathologic factors influencing the prognosis of vaginal carcinoma are FIGO staging, pathological type, and the longer the length of vaginal invasion, the worse the prognosis of the patients. Meta analysis of the value of radiotherapy and surgery in the treatment of vaginal carcinoma objective: to evaluate the value of radiotherapy and surgery in the treatment of vaginal carcinoma. Methods: the Chinese biomedical literature database was searched. From January 1, 2003 to October 30, 2013, papers were published to evaluate the effect of radiotherapy (鹵chemotherapy), surgery (鹵chemotherapy) and radiotherapy (鹵chemotherapy) on the prognosis of vaginal cancer. The survival rate was used as the observation index, and the follow-up data were clear in the original literature. The heterogeneity of each study and the extraction of each effect quantity were combined and inferred by statistical software STATAl1.0. Results: there was no significant difference in 5-year survival rate between surgery, radiotherapy and surgical radiotherapy. Conclusion there is no significant difference in 5-year survival rate among different treatment methods. The treatment of vaginal cancer needs to integrate the general situation of patients, clinical stage, pathological type, location of cancer, and so on, conclusion the results of the meta-analysis showed that there was no significant difference in the 5-year survival rate among the different treatments. Under the premise of as safe as possible and reducing the complications after treatment, simple operation, simple radiotherapy or surgical radiotherapy were used, and chemotherapy was used to improve the prognosis.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.34

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本文編號(hào)：2142509