【摘要】：目的:研究血清鱗狀癌細胞抗原SCCA與早期宮頸鱗癌臨床生物學(xué)行為的相關(guān)性并探討其與患者3年、5年生存率及無瘤生存時間(DFS)、總生存時間(OS)的相關(guān)性,揭示術(shù)前SCCA與早期宮頸鱗癌患者臨床生物學(xué)行為的關(guān)系,分析術(shù)前血清SCCA與早期宮頸鱗癌預(yù)后的關(guān)系。方法:收集2008年01月至2011年12月期間皖南醫(yī)學(xué)院第一附屬醫(yī)院弋磯山醫(yī)院收治的Ia期~IIa期宮頸鱗癌患者197例,所有患者初始治療均為手術(shù)治療�；仡櫺苑治鲂g(shù)前血清學(xué)SCCA與早期宮頸鱗癌患者年齡、臨床分期、淋巴結(jié)轉(zhuǎn)移、癌灶直徑、宮頸肌層浸潤深度、脈管浸潤的相關(guān)性。隨訪所有患者術(shù)后血清SCCA水平,分析患者術(shù)前術(shù)后SCCA水平有無統(tǒng)計學(xué)差異,評估治療效果;對比分析術(shù)后血清SCCA轉(zhuǎn)陰組與未轉(zhuǎn)陰組的生存情況有無差異。分別隨訪術(shù)前SCCA陽性組與陰性組患者3年、5年生存率、無瘤生成時間(DFS)及總生存時間(OS),分析術(shù)前SCCA情況與患者預(yù)后的關(guān)系。結(jié)果:術(shù)前SCCA表達情況與早期宮頸鱗癌患者臨床分期、淋巴結(jié)轉(zhuǎn)移、癌灶直徑、宮頸肌層浸潤深度、脈管轉(zhuǎn)移等密切相關(guān),差異有統(tǒng)計學(xué)意義(P0.05),而與病理組織學(xué)分級無關(guān)(P0.05),且不受年齡因素影響(P0.05)。187例患者術(shù)前血清學(xué)SCCA水平(3.29±5.71)ng/ml,術(shù)后第三月復(fù)查血清學(xué)SCCA值(1.15±1.38)ng/ml,經(jīng)統(tǒng)計學(xué)分析,差異有統(tǒng)計學(xué)意義(P0.05)。術(shù)前SCCA陽性組患者49例術(shù)后SCCA下降至正常者(n=43)的總生存時間(OS)優(yōu)于未降至正常者(n=6)(P0.05)。術(shù)前SCCA陰性組的無瘤生存時間及3年、5年無瘤生存率均優(yōu)于術(shù)前陽性組(P0.05)。術(shù)前SCCA陰性組的3年生存率與術(shù)前陽性者相比無明顯差異(P0.05);但是,隨著時間的推移,術(shù)前SCCA陽性患者的生存率明顯要差于陰性者(P0.05),而且術(shù)前SCCA陽性組的總生存時間(OS)也要明顯差于術(shù)前陰性組。結(jié)論:血清SCCA對早期宮頸鱗癌疾病進展及嚴重的程度的評估有重要意義;并可以作為一種臨床治療效果的評價指標。SCCA在對早期宮頸鱗癌患者術(shù)后預(yù)后情況的預(yù)測及隨訪有重要意義。SCCA在早期宮頸鱗癌中陽性率并不是很高,仍不能作為早期宮頸鱗癌診斷標準,僅可作為一種輔助診斷指標。
[Abstract]:Objective: to study the correlation between serum SCCA and clinical biological behavior of early cervical squamous cell carcinoma (SCCA) and its correlation with 3-year survival rate, 5-year survival rate, tumor-free survival time (DFS) and total survival time (OS). To explore the relationship between preoperative SCCA and clinical biological behavior in patients with early cervical squamous cell carcinoma, and to analyze the relationship between preoperative serum SCCA and prognosis of early cervical squamous cell carcinoma. Methods: from January 2008 to December 2011, 197 patients with stage Ia or stage IIa cervical squamous cell carcinoma treated in the first affiliated Hospital of Southern Anhui Medical College were collected. The initial treatment of all patients was surgical treatment. The correlation between preoperative serological SCCA and age, clinical stage, lymph node metastasis, tumor focus diameter, depth of cervical myometrial infiltration and vascular infiltration in early stage of cervical squamous cell carcinoma was analyzed retrospectively. All the patients were followed up after the operation of serum SCCA level, analysis of patients before and after the SCCA level of statistical difference, evaluation of therapeutic effect, compared with the postoperative serum SCCA negative group and no negative group of survival. The 3-year, 5-year survival rate, tumor free time (DFS) and total survival time (OS) of SCCA positive group and negative group were followed up, respectively. The relationship between preoperative SCCA and prognosis was analyzed. Results: the expression of SCCA was closely related to the clinical stage, lymph node metastasis, tumor focus diameter, depth of cervical myometrial invasion and vascular metastasis in patients with early squamous cell carcinoma of the cervix. The difference was statistically significant (P0.05), but had no correlation with histopathological grade (P0.05), and was not affected by age factors (P0.05). The serum SCCA level was (3.29 鹵5.71) ng / ml in 187 patients before operation, and the serum SCCA value was (1.15 鹵1.38) ng / ml in the third month after operation. The difference was statistically significant (P0.05). The total survival time (OS) of 49 patients with SCCA positive before and after SCCA decreased to normal (nong43) was better than that of normal (n = 6) (P0.05). The tumor-free survival time, 3-year and 5-year tumor-free survival rate of SCCA negative group were better than those of preoperative positive group (P0.05). The 3-year survival rate in SCCA negative group was not significantly different from that in pre-SCCA positive group (P0.05); however, as time went on, The survival rate of SCCA positive patients was significantly worse than that of negative SCCA patients (P0.05), and the total survival time (OS) of SCCA positive patients was significantly worse than that of preoperative negative SCCA patients. Conclusion: serum SCCA is of great significance in evaluating the progression and severity of early squamous cell carcinoma of the cervix. SCCA has important significance in predicting and following up the postoperative prognosis of patients with early squamous cell carcinoma of the cervix. The positive rate of SCCA in early squamous cell carcinoma of the cervix is not very high. It can not be used as diagnostic criteria for early squamous cell carcinoma of the cervix and can only be used as an auxiliary diagnostic index.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.33

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