原发性阴道恶性肿瘤(附26例报告)

Diagnosis and treatment of primary malignant tumor of vagina (with 26 cases)

目的探讨原发性阴道恶性肿瘤的治疗及预后因素。方法回顾分析26例原发性阴道恶性肿瘤的诊治情况及预后因素。结果鳞癌21例、腺癌3例、恶性黑色素瘤1例、内胚窦瘤1例。经综合治疗后,总体5年生存率为50.0%,I、II、III及Ⅳ期分别为:64.3%、42.9%、25.0%及0,P<0.05;I、II及III级分别为66.7%、40.0%及33.3%,P<0.05;鳞癌、腺癌、恶性黑色素瘤及内胚窦瘤分别为52.4%、66.7%、0及0,P<0.01;按阴道受侵长度<1/3、1/3~2/3、>2/3分为3个组,3组分别为63.2%、20.0%及0,P<0.01;按肿瘤直径大小<2cm、2cm^5cm、>5cm分为3个组,3组分别为69.2%、37.5%及20.0%,P<0.05。结论原发性阴道恶性肿瘤多采用综合治疗,其预后与肿瘤临床分期、病理分级、病理类型、阴道受侵长度及肿瘤直径大小有关。

Objective To explore the prognostic factors and therapy of primary malignant tumor of vagina. Methods The experience in diagnosis and treatment of 26 primary malignant tumor cases retrospectively analyzed. Results There 21 cases with squamous carcinoma, 3 cases with adenocarcinoma, 1 ease with malignant melanoma and 1 ease with endadermal sinus tumor were treated with integrated techniques and their five - year survival rate was 50.0%, the five - year survival rates of those at stage Ⅰ, Ⅱ , Ⅲ and Ⅳ were 64.3？% , 42.9% , 25.0% and 0 respectively, showing significant differences（ p 〈 0.05） . The five - year survival rates for those at grade Ⅰ,Ⅱ and Ⅲ were 66.7%, 40.0% and 33.3% respectively, also showing significant differences （P 〈 0.05）. The five - year survival rates of thosed with squamous carcinoma, adenocareinoma, malignant melanoma and endodermal sinus tumor were 52.4%, 66.7%, 0 and 0 respectively, showing significant differences （ P 〈 0.01）. The five - year survival rates in those involved with vaginal length of 〈 1/3, 1/3 - 2/3, 〉 2/3 were 63.2%, 20.0% and 0 respectively （P 〈 0.01） The five year survival rates of those with tumor size of 〈 2cm, 2cma - 5cm, 〉 5cm were 69.2 %, 37.5 % and 20.0% respectively （ P 〈 0.05）. Conclusion The prognosis of primary malignant tumor of vagina after treated with integrated methods was associated with the stage, grade, pathologic type, vaginal length involved and tumor size.