ⅢC期宫颈癌术后失败的病理危险因素探究

Investigation in the pathological risk factors for operative failure of stage ⅢC cervical cancer

目的 探究ⅢC期宫颈癌术后失败的病理危险因素,以期提高患者的预后。方法 选取2016年1—12月在福建省肿瘤医院妇科放疗科收治的宫颈癌根治术后淋巴结阳性患者82例,通过回顾性分析,总结患者的临床特征,分析宫颈癌术后局部复发和远处转移相关因素,分析各项因素对宫颈癌局部复发和远处转移的影响。结果 28例出现局部复发,复发率为34.15%,29例出现远处转移,转移率为35.36%。单因素分析提示淋巴结转移数量、髂总淋巴结有无转移、局部病理分期、术后有无放疗是影响宫颈癌术后局部复发和远处转移的因素,年龄、术后有无化疗也是影响宫颈癌术后远处转移的因素。logistic多因素回归分析结果显示,淋巴结转移数量是宫颈癌术后局部复发的独立影响因素(P<0.05);髂总淋巴结转移、淋巴结转移数量为宫颈癌术后远处转移的独立影响因素(P<0.05)。结论 淋巴结转移数量为宫颈癌术后失败的独立影响因素,临床上应注意对不同程度ⅢC期宫颈癌患者进行分层看待。

Objective To investigate the pathological risk factors for operative failure of stage Ⅲ C cervical cancer, so as to improve the prognosis of patients in future treatments. Methods A total of 82 patients with positive lymph nodes after radical resection of cervical cancer(RRCC) admitted to the Department of Gynecologic Radiotherapy of Fujian Cancer Hospital from January to December 2016 were selected as the study subjects. The clinical features of patients were summarized, and factors related to local recurrence and distant metastasis after RRCC were analyzed through retrospective analysis. Besides, the impacts of various factors on local recurrence and distant metastasis of cervical cancer were analyzed. Results Local recurrence was found in 28 cases, with a recurrence rate of 34.15%, and distant metastasis was found in 29 cases, with a metastasis rate of 35.36%. Univariate analysis suggested that the number of lymph node metastasis, the presence or absence of common iliac lymph node metastasis, local pathological staging and the presence or absence of postoperative radiotherapy were factors influencing postoperative recurrence and metastasis of cervical cancer, age and postoperative chemotherapy was also a factor influencing postoperative distant metastasis of cervical cancer.Logistic multivariate regression analysis showed that the number of lymph node metastasis was an independent influencing factor for local recurrence of cervical cancer after RRCC(P< 0.05). The common iliac lymph node metastasis and the number of lymph node metastasis were independent influencing factors for distant metastasis after RRCC(P< 0.05). Conclusion The number of lymph node metastasis is an independent influencing factor for postoperative failure of cervical cancer, and clinical workers should treat patients with different levels of stage Ⅲ C cervical cancer with separative ways.