吸烟对宫颈癌预后影响的病例对照研究

A Case-Control Study for the Role of Smoking in Cervical Cancer Prognosis

目的:通过临床配对研究,回顾性分析吸烟人群子宫颈癌患者的临床及病理资料,探讨吸烟对宫颈癌进展以及预后的影响。方法:选取年龄相差2岁以内;居住在同一地市区;就诊时间相差2个月以内共84例宫颈癌手术患者,按1∶2配对研究,分为吸烟组28例,非吸烟组56例。分析吸烟与宫颈癌临床病理因素之间的关系及与宫颈癌预后的关系。结果:吸烟与宫颈间质浸润深度(P=0.009)、盆腔淋巴结状态(P=0.025)、平均生存时间(P=0.003)、5年总生存率(OS)(P=0.008)、5年无进展生存率(PFS)(P=0.002)以及是否出现肿瘤复发(P=0.021)密切相关。与吸烟组相比,非吸烟组宫颈癌平均生存时间显著延长。特别针对Ⅰ-ⅡA期患者,吸烟组平均生存时间(104.133±14.328)个月,而非吸烟组为(140.073±7.204)个月,二者有显著性差异(P<0.05)。多因素分析显示,发现吸烟、淋巴结状态、临床分期是影响5年生存的独立预后因素。结论:吸烟可促进宫颈癌进展,进而影响宫颈癌预后。

Objective：To investigate the effect of smoking on cervical cancer progression and prognosis by retrospective analysis of clinical and pathological data of cervical cancer patients among smoking population.Methods：A total of 84 cervical cancer surgery patients with peered area,age,and treatment were divided into smoking group（n=28）and non-smoking group（n=56）.We retrospectively studied the relationship between smoking and cervical cancer clinical pathological factors and prognosis of cervical carcinoma.Results：Smoking was significantly correlated with cer-vical stromal invasion depth（P=0.009）,pelvic lymph node status（P=0.025）,the mean survival time（P=0.003）,5-year OS（P=0.008）,5-year PFS（P=0.002）,and the tumor recurrence（P=0.021）.Compared with smoking group,mean survival time of non-smoking cervical patients was noticeable longer.Especially forⅠ-ⅡA patients,the mean survival time of smoking vs non-smoking group were（104.133±14.328）vs（140.073±7.204）months with significant difference（P〈0.05）.Multivariate analysis showed that smoking,lymph node status,and clinical stage were independent prognostic factors for 5-year survival.Conclusion：Smoking may promote cancer progression,thereby affects the prognosis of cervical cancer.