宫颈腺癌321例卵巢转移情况的临床分析

Clinical analysis of ovarian metastasis in 321 patients with cervical adenocarcinoma

目的:探讨宫颈腺癌卵巢转移的发生率及危险因素。方法:回顾分析1990年1月至2012年8月在浙江省肿瘤医院行手术治疗的321例宫颈腺癌的临床病理资料,所有患者均切除双侧附件。分析患者的临床病理特点,探讨宫颈腺癌卵巢转移的高危因素。结果:16例患者出现卵巢转移(4.98%),中位年龄52±13岁。单因素分析显示,子宫体受累、淋巴结转移、浸润深度大于1/2、期别大于ⅠB期、宫旁侵犯是卵巢转移的高危因素。多因素分析显示,宫旁侵犯是唯一的独立高危因素。16例患者的2年及5年生存率分别为81.3%和62.5%。结论:宫颈腺癌卵巢转移的发生率高于宫颈鳞癌,对于有高危因素的患者,保留卵巢需慎重。

Objective：To investigate the incidence and the risk factors of ovarian me- tastasis in patients with cervical adenocarcinoma. Methods ：321 patients with cervical adenocar- cinoma were treated at Zhejiang Cancer hospital between Jan. 1990 and Aug. 2012. All the pa- tients received bilateral salpingo-oophoreetomy. Clinical and histopathologic data were reviewed to determine the risk factors of ovarian metastasis by analyzing the characteristic factors of the clinicopathological features. Results： Overall, Ovarian metastasis was detected in 16 patients （4.98%）. The median age was 52＋_13 years old. Univariate analysis indicated that uterine cor- pus involvement, lymph nodes metastasis, deep stromal invasion, FIGO stage more than stage I a, parametrium involvement were the risk factors of ovarian metastasis. But muhivariate analy- sis showed parametrium involvement was the only independent predictor of ovarian metastasis. The 2-year and 5-year survival rate was 81.3% and 62.5% , respectively. Conclusions：Ovarian metastasis occurred more frequently in patients with adenocarcinoma than in patients with squa- mous cell carcinoma. Ovarian preservation in those with increased risks of ovarian metastasis should be reconsidered.