宫颈癌骨转移患者临床病理特征与生存预后分析

Clinicopathological characteristic and prognosis of cervical cancer patients with bone metastasis

目的探讨宫颈癌骨转移患者的临床病理特征,并分析其与患者预后的关系。方法选取2010年11月至2019年11月福建医科大学附属漳州市医院收治的宫颈癌骨转移患者31例,回顾患者临床资料并随访其生存预后。采用Kaplan-Meier法绘制生存曲线,分析患者中位无进展生存期和中位总生存期。采用log-rank检验进行亚组分析,比较各临床病理因素对患者预后的影响。结果31例宫颈癌骨转移患者发生骨转移后,3年总生存率为35.5%(11/31),5年总生存率为12.9%(4/31),中位总生存期为677 d,中位无进展生存期为239 d。年龄>45岁的宫颈癌骨转移患者中位总生存期长于≤45岁患者(P<0.05)。有淋巴结转移的患者中位总生存期短于无淋巴结转移患者(P<0.05)。1年内发生骨转移的患者中位总生存期较短(P<0.05)。与单纯骨转移患者相比,合并骨外转移患者中位总生存期较短(P<0.05)。多发骨转移患者中位总生存期短于单发骨转移患者(P<0.05)。鳞癌患者与非鳞癌患者中位总生存期比较差异无统计学意义(P>0.05)。低分化患者与中分化患者中位总生存期比较差异无统计学意义(P>0.05)。结论宫颈癌骨转移患者以骨盆为主要转移部位,组织分化以低中分化为主。年轻(≤45岁)、初诊有淋巴结转移、确诊宫颈癌1年内发生骨转移、多发骨转移、合并骨外转移灶的患者预后较差。

Objective To analyze the clinicalpathological characteristic and prognosis of cervical cancer patients with bone metastasis.Methods The clinicopathological data of 31 cervical cancer patients with bone metastasis were reviewed.The median progression-free survival(PFS)and median overall survival(OS)were analyzed with Kaplan-Meier method.The related factors affecting the prognosis of patients were analyzed with log-rank test.Results In 31 cervical cancer patients with bone metastasis,the 3-year and 5-year OS rate was 35.5%(11/31)and 12.9%(4/31),respectively.The median OS and PFS was 677 days and 239 days,respectively.The median OS of patients aged>45 years was better than that of patients aged≤45 years(P<0.05).The median survival was shorter in patients with lymph node metastasis than that in patients without lymph node metastasis(P<0.05).Patients who developed bone metastasis within 1 year had a shorter survival(P<0.05).Patients with extraosseous metastasis had shorter survival time compared with patients with bone metastasis alone(P<0.05).The median survival time of patients with multiple bone metastases was shorter than that of patients with solitary bone metastases(P<0.05).There was no significant difference in median OS between patients with squamous cell carcinoma and those with non-squamous carcinoma,between patients with well differentiated cancer and those with poorly or moderately differentiated cancer(P>0.05).Conclusion Cervical cancer patients with younger age(≤45 years),newly diagnosed lymph node metastasis,bone metastasis within 1 year,multiple bone metastases,and extraosseous metastasis have a poor prognosis.