宫颈鳞癌根治术中卵巢移位术与卵巢埋藏术的预后比较

CERVICAL SQUAMOUS CARCINOMA OF OVARIAN TRANSPOSITION IN THE RADICAL HYSTERECTOMY AND OVARIAN BURIED PREOPERATIVE PROGNOSTIC COMPARISON

目的探讨对年轻早期官颈鳞状细胞癌患者行根治性治疗的同时,行卵巢移位术与卵巢埋藏术的预后的比较。方法回顾2002～2006我院收治的年龄40岁以下的宫颈鳞状细胞癌患者66例。临床分期均ⅠB～ⅡA期。其中在宫颈癌根治术中行卵巢移位术36例为观察组;在宫颈鳞状细胞癌根治术中行卵巢埋藏术30例为对照组。术后行B超及监测血FSH、LH、E2、P及应用Kup-permann评分[1]测定卵巢功能,随访5年。结果观察组中36例患者术后卵巢功能均正常,持续2年卵巢功能未出现减退(占100%),至术后5年有1例出现卵巢功能减退(占3%),对照组30例患者于术后3～6个月卵巢功能逐渐恢复,持续2年后4例出现卵巢功能减退(占13%),至5年有14例出现卵巢功能减退(占47%),两组间差异有显著性(p<0.05),两组记录生存质量的Kuppermann评分[1]比较差异有显著性(p<0.05);观察组肝转移1例,无死亡病例,对照组输尿管、膀胱转移1例,无死亡病例,复发率和存活率比较差异无显著性意义(p>0.05)。结论宫颈鳞状细胞癌根治术中卵巢移位术后卵巢功能较卵巢埋藏术后的卵巢功能恢复好,卵巢衰竭慢,术后生存质量均优于卵巢埋藏术。而复发率和存活率比较差异无显著性差异(p>0.05)。

Objective To explore the young early cervical squamous cell cancer patients underwent radical treatment at the same time, ovary transposition and postoperative prognosis of ovarian buried comparison. Methods a retrospective review of 2002 ~ 2006 in our hospital were under the age of 40 in cervical squamous cell carcinoma and 66 patients with clinical stage I. B II A period. In radical surgery of cervical carcinoma, ovarian transposition for the observation of 36 cases of group; in radical hysterectomy for cervical squamous cell carcinoma ovarian buried in Bank of China as the control group of 30 cases. Postoperative B ultrasound and monitoring of blood FSH, LH, E2, P and Kuppermann score （ 1 ） determination of ovarian function, followed up for 5 years. Results in the observation group 36 cases ovarian function after hysterectomy were normal, lasts 2 years without loss of ovarian function （ 100% ）, to 5 years postoperatively in 1 cases of ovarian dysfunction （3%）, 30 cases in the control group, patients on the 3 postoperative 6 months of ovarian function gradually recovered, last 2 years later in 4 cases of ovarian dysfunction （ 13% ） , to 5 years there were 14 cases with ovarian dysfunction （47%）, the difference between the two groups was significant （p 〈 0. 05）, two groups of recording quality of life score of Kuppermann （ 1 ） there was a significant difference （p 〈0. 05） ; the observation group 1 cases with liver metastasis, no death case, the control group the ureter, bladder metastasis in ! cases, no deaths, and the rate of recurrence and survival rates compared with no sig- nificant difference （p 〉 O. 05）. Conclusion cervical squamous cell carcinoma of ovarian transposition in the radical hysterectomy with ovarian ovarian function after buried in postoperative recovery of ovarian function, o- varian failure is slow, the postoperative survival quality are better than ovarian buried operation. But the recurrence rate and survival rate had no significant difference among the difference （p 〉 0. 05）.