早期宫颈癌患者围手术期外周血淋巴细胞数与其预后的关系

Correlation of the Changes of Postoperative Peripheral Lymphocyte Counts with the Prognosis of Early Cervical Cancer

目的：探讨早期宫颈癌患者围手术期外周血淋巴细胞数与其预后之间的关系。方法：回顾性分析2006年1月至2012年12年就诊于解放军总医院，根据2009年最新宫颈癌FIGo指南诊断为Ⅰb～ⅡA认期宫颈癌进行阴式宫颈癌根治术患者的临床病历资料。分析患者的围手术期淋巴细胞数和其无瘤生存期、总生存期间的关系。结果：共143例阴式早期宫颈癌根治术患者纳入研究，随访时间为6～87个月，中位随访时间为53个月。术后，宫颈癌患者外周血淋巴细胞数显著下降。术前外周血淋巴细胞数较高的患者无瘤生存期及总生存期均较外周血淋巴细胞数低于平均水平的患者显著延长（P〈0．05）；术后第三天淋巴细胞数恢复或高于术前水平的患者无瘤生存期较术后第三天淋巴细胞数低于术前水平的患者显著延长（P〈0．05），但总生存期无明显差异（P〉0．05）。COX回归分析显示术前淋巴细胞数高于平均水平及术后第三天淋巴细胞数高于或等于术前水平的宫颈癌患者的预后相对较好。结论：术前淋巴细胞数和术后第三天淋巴细胞数的变化均可作为评估宫颈癌术后患者预后的重要参考指标。

Objective： To investigate the relationship between postoperative peripheral lymphocyte counts and the prognosis of patients diagnosed with early cervical cancer. Methods： The patients diagnosed with clinically staged cervical cancer （IB to IIA） in PLA General Hospital from 2006 to 2012, who were treated by viginal type III radical hysterectomy were retrospectively reviewed. The relationship between post-operative peripheral lymphocyte counts and the disease-free survival and overall survival was analyzed. Results： 143 patients were included in this study. The median follow-up visit was 53 months with a range of 6-87 months. The peripheral lymphocyte counts decreased significantly after surgery. Longer disease-free survival and higher overall survival rate were observed in the patients with higher pre-operative peripheral lymphocyte counts （P〈0.05）. The patients who had increased or equal peripheral lymphocyte counts to pre-operative level showed significantly longer disease-free survival （P〈0.05）, but no significant difference was observed in the overall survival （P〉0.05）. Cox regression analysis showed that patients with higher pre-operative peripheral lymphocyte counts and recovery of lymphocyte counts on post-operative day 3 counts had better prognosis. Conclusion： Pre-operative peripheral lymphocyte counts and change of lymphocyte counts on post-operative day 3 could be regarded as important independent prognostic factors of patients with cervical cancer.