妊娠相关性宫颈癌19例临床分析

Clinical Analysis of 19 Cases of Cervical Cancer Associated with Pregnancy

目的:分析妊娠相关性宫颈癌的临床病理资料及影响预后的因素,探讨妊娠相关性宫颈癌的治疗方案。方法:收集2000年1月至2006年12月收治的19例妊娠相关性宫颈癌患者的临床资料进行回顾性分析,用Kaplan-Meier法、Log-rank检验、COX回归模型进行统计学分析。结果:19例妊娠相关性宫颈癌患者中位生存时间为34.33个月,5年生存率为46.62%。单因素分析显示肿瘤大小(P=0.034)、FIGO临床分期(P=0.046)、组织学分级(P=0.047)、终止妊娠的方式(P=0.033)、根治性手术(P=0.020)、淋巴结转移(P=0.016)与预后有关。多因素分析显示是否行根治性手术(P=0.021)、淋巴结转移(P=0.012)是影响预后的独立因素。结论:对于妊娠相关性宫颈癌,是否行根治性手术、淋巴结转移是影响预后的独立因素,行宫颈癌根治术手术可以延长生存时间。

Objective： To analyze the clinic-pathologic characteristics and prognostic factors of cervical cancer associated with pregnancy to provide the references of clinical treatment. Methods： Retrospectivelly reviewed the clinical data of 19 patients with cervical cancer associated with pregnancy who were treated from January 2000 to December 2006, Kaplan-Meier method,log-rank test, and COX regression model were used for analysis. Results ：The overall median survival time of 19 patients was 34.33 months. The 5-year o- verall survival rate was 46.62%. The tumor size （ P =0.034）, FIGO stage（ P =0.046）, histology differentia- tion（ P =0.047）, the method of termination of pregnancy （ P = 0.033 ）, radical surgery （ P = 0.020 ）, lymph node metastasis （P =0.016）were correlated with the prognosis by univariate analysis. The radical surgery （P =0.021 ）and lymph node metastasis （P = 0. 012）were independent prognostic factors by multivariate a- nalysis. Conclusions：lymph node metastasis and radical surgery are independent prognostic factors for cer- vical cancer associated with pregnancy, radical surgery might improve the overall survival.