术前接受新辅助化疗的ⅠB2和ⅡA2期宫颈癌患者的疗效和预后相关的影响因素研究

Study the curative effects and the influence factors of treatment prognosis for stageⅠB2 andⅡA2 cervical cancer patients using the preoperative neoadjuvant chemotherapy

目的探讨术前接受新辅助化疗的ⅠB2和ⅡA2期宫颈癌患者的疗效和预后相关的影响因素。方法选取我院妇产科收治欲行手术治疗的ⅠB2和ⅡA2期宫颈癌患者,所有患者入院均接受新辅助化疗后进行手术,回顾性分析患者的临床资料,根据治疗效果的差异分为有效组和无效组,比较两组的一般资料,采用Logistic回归方程分析影响患者疗效和预后相关的影响因素。结果86例患者经治疗后CR人数15例、PR人数27例、SD人数18例、PD人数12例;最终纳入有效组60例(69.77%);纳入无效组26例(30.23%)。单因素分析显示有效组和无效组在肿瘤直径、NLR、MLR、SIRI、术后盆腔淋巴结转移率和宫颈深肌层浸润率方面对比存在明显差异(P<0.05),以患者的治疗效果为因变量,以一般资料中具有统计学意义的因素为自变量进行Logistic回归方程分析,结果显示:NLR、MLR、SIRI、盆腔淋巴结转移和宫颈深肌层浸润是导致患者治疗无效的危险因素(均OR>1,均P<0.05)。结论术前接受新辅助化疗的ⅠB2和ⅡA2期宫颈癌患者虽具有一定效果,但易受多种因素影响,其中血清炎症因子及癌细胞转移、浸润程度是影响疗效的关键因素。

Objective To discuss the curative effects and the influence factors of treatment prognosis for stageⅠB2 andⅡA2 cervical cancer patients using the preoperative neoadjuvant chemotherapy.Methods StageⅠB2 andⅡA2 cervical cancer patients(2018.01~2021.10)in our obstetrics and gynecology department were selected.The preoperative neoadjuvant chemotherapy was performed.Clinical data was acquired.According to treatment effects,patients were assigned to valid group and invalid group.Logistic regression equation was used to analyze the curative effects and the influence factors of treatment prognosis.Results Among 86 patients,there were 15 CR cases,27 PR cases,18 SD cases and 12 PD cases;60 cases were eventually included in the valid group(69.77%)and 26 cases in the invalid group(30.23%).The univariate analysis results showed that there were significant differences about the tumor diameter,NLR(neutrophil-to-lymphocyte ratio),MLR(monocyte-to-lymphocyte ratio),SIRI(systemic inflammation response index)and pelvic lymph node metastasis and cervical deep intramuscular invasion rates(P<0.05);curative effects were set as the dependent variables;the statistical information factors were set as the independent variables.Logistic regression equation showed that the risk factors of failed treatment were NLR,MLR,SIRI,pelvic lymph node metastasis and cervical deep intramuscular invasion(OR>1,P<0.05).Conclusion The preoperative neoadjuvant chemotherapy produces a certain effect on the curative effects of stageⅠB2 andⅡA2 cervical cancer patients;however,there are multiple influence factors of treatment prognosis,especially for serum inflammatory factors,cancer cell metastasis and invasion degrees.