血清肌酐和早期宫颈腺癌妇女术后生存状况的关系研究

Relationship between serum creatinine and postoperative survival in women with early cervical adenocarcinoma

目的:分析血清肌酐(Serum Creatinine,Scr)和早期宫颈腺癌(Adenocarcinoma,ADC)妇女术后生存状况的关系。方法:对2018年6月至2021年6月期间于我院进行手术治疗的188例ADC患者展开回顾性分析,所有患者均完成1 y随访,依据生存状况将188例患者分为死亡组(n=27)和对照组(n=161)。比较两组患者的各项资料,进一步行Logistic多因素分析,明确ADC妇女术后死亡的危险因素,并以Pearson相关性分析Scr与各项危险因素的相关性,以ROC曲线分析Scr对ADC妇女术后生存状况的预测价值。结果:死亡组患者的产次≥3次、卵巢转移、临床分期为Ⅱa期、瘤体≥4 cm、淋巴结转移、单纯手术的占比均高于对照组,Scr水平、血尿素氮(Blood urea nitrogen,BUN)水平均高于对照组,住院时间长于对照组(P<0.05)。Logistic多因素分析显示,产次≥3次、淋巴结转移、单纯手术、Scr≥75μmol·L^(-1)为ADC妇女术后死亡的危险因素(P<0.05)。Scr水平与产次、淋巴结转移、单纯手术均呈现正相关(P<0.05)。以Scr为指标绘制ADC妇女术后生存状况的ROC曲线,AUC=0.8614,95%CI为0.738-0.856(P=0.003)。结论:产次、淋巴结转移、单纯手术、Scr为ADC妇女术后死亡的危险因素,且Scr对ADC妇女术后生存状况有较佳的预测价值。

Objective:To analyze the relationship between Serum Creatinine(Scr)and postoperative survival in women with early cervical Adenocarcinoma(ADC).Methods:A retrospective analysis was performed on 188 ADC patients who underwent surgical treatment in our hospital from June 2018 to June 2021.All patients completed 1-year followup,and 188 patients were divided into death group(n=27)and control group(n=161)according to their survival status.The data of the two groups were compared,and Logistic multivariate analysis was performed to identify the risk factors for postoperative mortality in ADC women.Pearson correlation was used to analyze the correlation between Scr and various risk factors,and ROC curve was used to analyze the predictive value of Scr for postoperative survival in ADC women.Results:The proportion of parities≥3,ovarian metastasis,clinical stageⅡa,tumor size≥4 cm,lymph node metastasis and simple surgery in the death group were higher than those in the control group,the level of Scr and Blood urea nitrogen(BUN)were higher than those in the control group,and the length of hospital stay was longer than that in the control group(P<0.05).Logistic multivariate analysis showed that parity≥3 times,lymph node metastasis,simple operation,Scr≥75μmol·L^(-1) were risk factors for postoperative mortality in ADC women(P<0.05).Scr level was positively correlated with parities,lymph node metastasis,and simple surgery(P<0.05).The ROC curve of postoperative survival of ADC women was drawn with Scr as the index,and the AUC was 0.8614,95%CI was 0.738-0.856(P=0.003).Conclusions:Parity,lymph node metastasis,simple operation and Scr are risk factors for postoperative mortality in ADC women,and Scr has a good predictive value for postoperative survival in ADC women.