中晚期宫颈鳞癌放化疗后复发未控的临床危险因素分析

Uncontrolled clinical risk factors of the recurrence of advanced cervical squamous cell carcinoma after radiotherapy and chemotherapy

目的:探讨中晚期宫颈鳞癌放化疗后复发未控临床危险因素,为临床预防和治疗提供依据。方法:通过分析2014年10月至2015年8月医院收治的168例中晚期宫颈鳞癌患者的临床资料,根据是否复发分为复发组(观察组)和未复发组(对照组),对比分析两组患者临床资料,并使用Logistic多因素回归分析影响患者复发未控的危险因素。结果:两组患者临床资料单因素分析结果显示两组患者病灶直径、肿瘤分化程度、化疗时间和治疗前是否转移、血红蛋白水平比较差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,患者肿瘤直径>4cm、肿瘤分化程度低、化疗时间<3个疗程、放疗时间>8周、发生淋巴结转移、血红蛋白水平较低是影响中晚期宫颈鳞癌患者放化疗后复发的未控独立危险因素。结论:临床影响中晚期宫颈鳞癌患者放化疗后复发未控临床危险因素较多,临床治疗中应根据患者病情进行针对性治疗,降低患者治疗后复发风险。

Objectives： To investigate the uncontrolled clinical risk factors of the recurrence of advanced cervical squamous cell carcinoma after radiotherapy and chemotherapy, in order to provide basis for its clinical prevention and treatment. Methods： The clinical data of 168 patients with advanced cervical squamous cell carcinoma from October 2014 to August 2015 was analyzed. The patients were divided into recurrent group （ observation group） and nonrecurrent group （control group）. The clinical data of patients in the two groups was compared and analyzed with Logistic regression to identify the uncontrolled clinical risk factors of the recurrence. Results： According to the univariate analysis, difference in the lesion diameter, tumor differentiation, chemotherapy treatment time, existence of the transfer and hemoglobin level was statistically significant （ P 〈 0. 05 ）. According to the multivariate Logistic regression analysis, factors including tumor size 〉 4cm, low tumor differentiation, chemotherapy time 〈 3 courses, radiotherapy time 〉 8w, lymph node metastasis and low hemoglobin level were all independent uncontrolled risk factors of the recurrence of advanced cervical squamous cell carcinoma. Conclusion： There are many kinds of factors affecting the recurrence of advanced cervical squamous cell carcinoma in clinical, so targeted measures should be taken to reduce the risk of recurrence.