宫颈癌手术治疗效果观察及预后因素分析

Observation and prognosis analysis of cervical cancer patients after surgical operation

目的分析个体化手术治疗Ia-Ⅱb期宫颈癌患者生存状态,探讨影响预后的高危因素。方法对我院2004-2009年期间宫颈癌211例患者手术治疗后生存状态进行分析,累计生存曲线通过Kaplan-Meier法计算,以表示患者的预后情况。单因素分析采用Log-rank检验,多因素分析采用Cox回归分析,以探讨影响预后的因素。结果 211例宫颈癌患者的临床分期为Ia期23例,Ib1期73例,Ib2期77例,Ⅱa期为20例,Ⅱb为18例,5年生存率分别是100.00%、95.83%、83.02%、78.95%、61.11%。手术治疗Ⅰa-Ⅱb期宫颈癌患者的5年生存率为87.04%。单因素分析提示临床分期、宫颈肌层浸润程度、淋巴结转移情况与宫颈癌预后相关(P<0.05),多因素分析发现临床分期与宫颈癌预后有关,RR(95%CI)=2.27(1.66,3.11)。结论手术治疗Ia期-Ⅱb期宫颈癌患者的5年生存率为87.04%,临床分期的逐级变化与宫颈癌预后有关。

Objective To study the survival situation after surgical operation of the cervical cancer patients from stage-Ia to stage-IIb and explore their high-risk factors of prognosis. Methods 211 surgery cervical cancer patients during 2004 to 2009 were included in this study. Kaplan-Meier method was used to obtain the survival rate; Log-rank test and Cox model multi-factor analysis were used to investigate the prognosis correlation factors. Results The 5-year survival rates of patients with cervical cancer at stages Ia（23 cases）, Ib1（73 cases）, Ib2（77 cases）, Ⅱ a（20 cases） and Ⅱ b（18 cases） were 100.00%, 95.83%, 83.02%, 78.95% and 61.11%, respectively. The 5-year survival rate of the 211 patients was 87.04%. The single factor analysis showed that different clinical stages, cervical muscular infiltration and lymph node metastasis have relationship with cervical cancer prognosis（P〈0.05）. However, multi-factor analysis showed that only pathological stage was related to the cancer prognosis, RR（95% CI） was 2.27（1.66, 3.11）. Conclusions The 5-year survival rate of the 211 patients was 87.04%. Clinical stage has relationship with cervical cancer prognosis.