原发性阴道癌的远期疗效及预后影响因素分析

Analysis of the factors associated with the long-term curative effect and prognosis of primary vaginal carcinoma

目的探讨影响原发性阴道癌患者预后的临床相关因素。方法对1999—2014年间辽宁省肿瘤医院妇科收治的有完整病理诊断、临床随访资料的118例原发性阴道癌患者进行回顾性研究，分析患者年龄、有无子宫切除史、病理类型、国际妇产科联盟（FIGO）分期、肿瘤大小、肿瘤生长部位、治疗方式等因素对患者预后的影响。结果118例原发性阴道癌患者的中位生存时间为93个月，1、3、5、10和15年生存率分别为89.7%、68.1%、60.4%、37.3%和19.0%。单因素分析结果显示，原发性阴道癌的FIGO分期、病理类型、肿瘤大小、治疗方式、肿瘤生长区段与患者的预后有关（均P〈0.05），而患者年龄、有无子宫切除史与患者的预后无关（均P〉0.05）。Cox多因素回归分析显示，FIGO分期（P＝0.008）、肿瘤生长区段（P＝0.001）、治疗方式（P＝0.007）为影响原发性阴道癌患者预后的独立因素。结论FIGO分期、病理类型、肿瘤大小、治疗方式和肿瘤生长区段与原发性阴道癌患者的预后有关，其中FIGO分期、肿瘤生长区段和治疗方式为影响原发性阴道癌患者预后的独立因素。

ObjectiveTo investigate the clinical factors that affect the prognosis of patients with primary vaginal cancer.MethodsClinical data of 118 primary vaginal cancer patients with pathological diagnosis and clinical follow-up data from the Department of Gynecology of Liaoning Cancer Hospital ＆ Institute from 1999 to 2014 were collected and retrospectively analyzed. The relationship of prognosis and factors including age, history of hysterectomy, pathological types, International Federation of Gynecology and Obstetrics （FIGO） stage, tumor size, tumor location and therapeutic methods were analyzed, respectively.ResultsThe median survival time of the 118 patients was 93 months. The survival rates of 1, 3, 5, 10 and 15-year were 89.7%, 68.1%, 60.4%, 37.3% and 19.0%, respectively.The results of univariate analysis showed that the FIGO stage, pathological types, tumor size, therapeutic methods and tumor location were related to the prognosis of patients with primary vaginal cancer （all P〈0.05）, while the patients′ age, history of hysterectomy were not （all P〉0.05）. The results of Cox multivariate regression analysis indicated that FIGO stage （P=0.008）, tumor location （P=0.001） and therapeutic methods （P=0.007） were independent prognostic factors of the patients with primary vaginal cancer. ConclusionsPrognostic factorsofpatients with primary vaginal cancer include FIGO stage, pathological types, tumor size, therapeutic methods and tumor location. Among them, therapeutic methods and tumor location are the independent prognostic factors.