宫颈癌治疗后复发和未控的相关因素分析

Analysis of clinical and pathological factors of persistent or recurrent cervical cancer

目的探讨宫颈癌治疗后未控、复发的高危因素。方法调查1996年1月至2000年12月间在山东省肿瘤医院门诊复诊的宫颈癌病例,共收集到5年以上无瘤生存病人246例(A组),5年内复发病人120例(B组)。对比初治时的发病年龄、婚育产次、临床分期、病理类型、肿瘤分化程度、肿瘤生长形态、肿瘤大小以及初治方法和完成情况。结果年龄、早婚、多产、贫血是宫颈癌复发的相关因素,差异有统计学意义;结节型、空洞型、颈管型宫颈癌复发率高,糜烂型宫颈癌复发率低,两组相比有统计学意义;临床期别晚、巨块型宫颈癌、分化程度低、腺癌、腺鳞癌宫颈癌复发率高,有统计学意义。关于宫颈癌的治疗,我们认为早期患者手术加放疗预后好,晚期化疗患者预后差,有统计学意义,临床期别晚的宫颈癌多采用放疗,其方式与预后没有明显关系,无统计学意义。结论本资料提示年龄,早婚多产,口服避孕药、宫颈浸润深度,肿块形态、大小,病理分型、分级、临床分期晚是影响宫颈癌的预后因素。

Objective： To study the prognostic factors associated with persistent or recurrent cervical cancer.Methods： Totally 366 cases of persistent or recurrent cervical cancer were retrospectively studied in Shandong Cancer Hospital between January,1996 and December,2000.Clinical and pathological data were collected,and clinical and pathological factors were retrospectively analysed,including 246 cases of patients with over 5 years cancer-free survival（A group）,and 120 cases patients of recurrence（B group）.Patient＇s age,marriage bearing times,clinical stage,pathological type,tumor differentiation,tumor growth patterns,tumor size,and initial treatment methods and the completion were studied.Results： Young cervical cancer,early marriage and prolificacy were related to recurrent cervical cancer,and there was statistical significance;Patients whose hemoglobin was less than 9 grams had high recurrent rate,and the difference had statistical significance;while nodular and cavitary type had a high recurrence rate of cervical cancer,cervical erosion type had a low recurrent rate and the difference had statistical significance compard with the two groups;Late clinical stage,giant block type of cervical cancer,a low degree of differentiation,adenocarcinoma,adenosquamous carcinoma were in with a high recurrent rate of cervical cancer recurrence rate remained high,and there was statistical significance.For the treatment of cervical cancer,early stage patients with surgery and radiotherapy had good prognosis,and late stage patients with advanced chemotherapy had poor prognosis,and the difference had statistical significance.Radiotherapy was adopted in the late clinical stage cervical cancer patients,and the manner had no significant relationship with the prognosis,and there was no statistical significance.Conclusion： Age,early marriage,prolificacy,oral contraceptives,depth of cervical invasion,tumor shape and size,pathological type and grade,late clinical stage are possible prognostic factors of recurrent cervical cancer.