本文關(guān)鍵詞： 宮頸小細(xì)胞癌 臨床特征 治療 預(yù)后 對(duì)比性研究　出處：《實(shí)用婦產(chǎn)科雜志》2017年04期 　論文類型：期刊論文

【摘要】：目的:對(duì)比性研究宮頸小細(xì)胞癌(SCCC)與宮頸非小細(xì)胞癌在發(fā)病特點(diǎn)、臨床特征、治療方案、預(yù)后情況等方面的差異,并探究影響其預(yù)后的因素。方法:回顧性分析2003年5月至2015年6月四川大學(xué)華西第二醫(yī)院收治的宮頸小細(xì)胞癌患者63例(SCCC組)和根據(jù)診斷時(shí)間及相近的FIGO分期配對(duì)的宮頸非小細(xì)胞癌(鱗癌、腺癌)患者60例(對(duì)照組)的臨床病理資料及生存情況,采用Pearson卡方檢驗(yàn)或Fisher確切概率法比較兩組臨床特征、治療方案等方面的差異,Kaplan-Meier方法比較兩組總體生存率及無(wú)病生存率的差異,單因素和多因素分析影響SCCC預(yù)后的因素。結(jié)果:(1)SCCC組患者初診的中位年齡較對(duì)照組年輕(40歲vs 44歲,P=0.001),淋巴結(jié)轉(zhuǎn)移率、宮旁浸潤(rùn)率、脈管累及率及手術(shù)切緣陽(yáng)性率也均顯著高于對(duì)照組(P0.05)。而在臨床癥狀、腫塊大小、診斷分期、術(shù)前治療、術(shù)后治療等方面比較兩者差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(2)生存分析中,SCCC組的累積5年生存率(29.2%)與累積5年無(wú)瘤生存率(26.6%),顯著低于對(duì)照組(分別為82.6%、76.7%),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)在影響SCCC預(yù)后的多因素COX多元回歸分析結(jié)果顯示,有淋巴結(jié)轉(zhuǎn)移是影響患者5年總生存率和5年無(wú)瘤生存率的獨(dú)立危險(xiǎn)因素(HR=4.784、3.067,P0.05)。腫塊直徑≥4 cm是影響5年總生存率的獨(dú)立危險(xiǎn)因素(HR=3.610,P0.05)和FIGO分期(ⅠB2以上)是影響無(wú)瘤生存率的獨(dú)立危險(xiǎn)因素(HR=2.793,P0.05)。結(jié)論:SCCC患者更年輕,其臨床癥狀、病灶外觀、治療方案等和宮頸非小細(xì)胞癌相似,但淋巴結(jié)轉(zhuǎn)移率、脈管累及率、宮旁浸潤(rùn)率及手術(shù)切緣陽(yáng)性率均顯著高于宮頸非小細(xì)胞癌,預(yù)后極差。影響SCCC患者預(yù)后的主要因素為有無(wú)淋巴結(jié)轉(zhuǎn)移、FIGO分期、腫塊直徑。
[Abstract]:Objective: to compare the differences between SCCCs and non-small cell carcinoma (NSCC) in the pathogenesis, clinical features, treatment and prognosis of cervical small cell carcinoma (SCCC), and to compare the differences between SCCCs and non-small cell carcinoma (NSCC). Methods: from May 2003 to June 2015, 63 cases of small cell carcinoma of cervix cervix treated in Huaxi second Hospital of Sichuan University were analyzed retrospectively. To non-small cell carcinoma of the cervix (squamous cell carcinoma, The clinicopathological data and survival status of 60 patients with adenocarcinoma (control group) were compared by Pearson chi-square test or Fisher exact probability method. Kaplan-Meier method was used to compare the overall survival rate and disease-free survival rate between the two groups. Results the median age, lymph node metastasis rate, para-uterine infiltration rate and the median age of patients with SCCC were 40 years younger than that of the control group, and the lymph node metastasis rate and para-uterine infiltration rate were higher than those in the control group (40 years old vs 44 years old), and the prognostic factors of SCCC were analyzed by univariate and multivariate analysis. The vascular involvement rate and the positive rate of surgical margin were significantly higher than those of the control group (P 0.05). There was no significant difference in survival analysis between the two groups in terms of postoperative treatment and survival analysis (P < 0.05). The cumulative 5-year survival rate of SCCC group was 29.22.The cumulative 5-year tumor-free survival rate of SCCC group was 26.6%, which was significantly lower than that of the control group (82.6% 76.7%, respectively). The results of multivariate COX regression analysis on the prognosis of SCCC showed that, Lymph node metastasis is an independent risk factor for 5-year overall survival and 5-year tumor-free survival in patients. Tumor diameter 鈮，

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