宫颈癌皮肤转移5例临床分析

Clinical analysis of cervical cancer with skin metastasis in 5 patients

目的探讨宫颈癌皮肤转移患者的临床特点、诊治过程及预后。方法我院自2006年6月至2011年6月共收治宫颈癌患者574例,其中5例确诊为宫颈癌皮肤转移。收集该5例患者的临床、病理及随访资料,并分析其临床特点、诊治过程及预后。结果宫颈癌皮肤转移的发生率为0.87%（5/574）,均为宫颈癌ⅡA~ⅢB期患者。其中,4例在确诊宫颈癌并完成治疗后的随访过程中发现皮肤转移;1例为初治患者,入院后1个月发现逐渐增大的皮肤结节,手术切除后确诊为皮肤转移。4例患者合并肺部、骨骼等其他部位的转移。4例患者行手术完整切除皮肤病灶,术后1例因合并有多发骨转移且骨痛明显接受核素治疗,1例行全身化疗,2例仅接受对症支持治疗。1例患者因头皮转移病灶向内侵犯颅骨,无法行手术切除,行穿刺检查诊断转移后接受调强适形放疗。随访中3例患者死亡,另2例诊断宫颈癌皮肤转移分别为3个月、5个月,仍存活。结论宫颈癌皮肤转移发生率低,通常合并有其他脏器的转移,治疗较困难,预后较差。

Objective To explore the clinical features, treatment and prognosis of cervical cancer patients with skin metasta-sis.Methods From June 2006 to June 2011, 574 cervical cancer patients were treated in our hospital, in which 5 cases was diag-nosed as cervical cancer with skin metastasis. The clinical, pathological and follow-up data of 5 patients were collected and their clini-cal features, treatment and prognosis were analyzed.Results The incidence rate of cervical cancer with skin metastasis was 0. 87%（5/ 574）, with stage ⅡA to ⅢB. Among them, 4 cases were diagnosed during the follow-up of cervical cancer. One patient was diag-nosed after resection in her first hospitalization. There were 4 patients with pulmonary, skeletal and other sites of metastasis. Fourpatients＇ skin lesions were excised completely including 1 patient underwent radionuclide therapy because of multiple bone metastasesand bone pain, one patient received systemic chemotherapy, 2 patients received only supportive and symptomatic treatment. One patientcouldn＇t receive complete excision because of metastatic lesions invading skull scalp inward, diagnosed by puncture examination,andunderwent conformal intensity modulated radiotherapy. During the follow-up, 3 patients died, 2 patients still alive.Conclusion Cervi-cal cancer with skin metastasis occurs at a low rate, usually combined with other organs＇ metastases, and its efficacy and prognosis ispoor.