子宫颈腺癌96例临床与预后相关因素分析

Analysis of the clinical and prognostic correlation factors in 96 cases of invasive cervical adenocarcinoma

目的 探讨子宫颈腺癌患者的临床和病理特征及预后的相关因素.方法 分析山西省肿瘤医院1998年1月至2007年12月收治的子宫颈腺癌96例患者临床及病理资料,简单随机法抽取同期子宫颈鳞状细胞癌患者100例作为对照.结果 腺癌发病率呈上升及年轻化趋势.患者5年总生存率为60.4％,其中Ⅰ、Ⅱ、Ⅲ、Ⅳ期分别为82.9％、51.5％、13.3％、0.子宫颈腺癌的预后影响因素包括临床分期、淋巴结转移、肿瘤的体积、肌层浸润深度、分化程度等.多因素分析显示,临床分期、淋巴结转移及肌层浸润深度是最重要的预后影响因素,是否保留卵巢与预后无关.对ⅠB期患者,综合治疗组的预后好于单纯手术组,但差异无统计学意义（P＞0.05）.结论 子宫颈腺癌的发病率为呈上升和年轻化趋势.早期诊断对于提高子宫颈腺癌患者的生存率非常重要.早期年轻的子宫颈腺癌患者保留卵巢不影响生存率.

Objective To analyze the clinicopathologic features,prognosis and influencing factors of invasive cervical adenocarcinoma.Methods Clinical and pathologic data of 96 cases of invasive cervical adenocarcinoma and 100 cases of squamous carcinoma of the cervix treated in Shanxi Cancer Hospital from years of 1998 to 2007 were retrospectively analyzed.Results The morbidity of cervical adenocarcinoma was showing the arise and low-age trend.The overall 5-year survival rate was 60.4 %,The overall survival rates of patients with stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ were 82.9 %,51.5 %,13.3 % and 0,respectively.Ocervical adenocarcinoma had many prognosis-related factors：clinical stage,lymmphatic spread,vascular invasion,volume of tumor,histologic grade.Multivariate analysis showed that clinical stage,lymph nodal metastasis and vascular invasion were independent prognosis-related factors.However,whether ovary was reserved,it was irrelative to prognosis.Conclusion The morbidity of cervical adenocarcinoma is showing the arise and low-age trend.Earlier diagnosis is extremely important for improving the survival rate of cervical adenocarcinoma,the reserved ovary doesn＇t influence the overall 5-year survival rate for young women with early cervical adenocarcinoma.