腹腔镜下宫颈癌根治术患者生存预后影响因素

Influence factors of survival prognosis of patients with cervical cancer after laparoscopic radical resection

目的:探讨宫颈癌(CC)腹腔镜下根治术患者生存预后影响因素。方法:回顾性采集2014年1月-2019年1月医本收治的CC腹腔镜下根治术患者426例临床病理资料,统计患者3年总生存率,据此分为死亡组、生存组。观察人口学资料、合并症、病理学资料、实验室检查资料、术后辅助治疗资料与CC腹腔镜下根治术患者生存预后的关系;采用Cox多因素回归分析患者生存预后独立影响因素;绘制受试者工作特征(ROC)曲线观察各独立影响因素对患者生存预后的预测效力。结果:426例术后3年生存399例(93.7%)归为生存组,死亡27例(6.3%)归为死亡组;FIGO分期ⅡA1~ⅡA2期、淋巴脉管间质浸润、SII水平高均为CC患者术后生存预后的独立危险因素,PNI水平高为独立保护因素(均P<0.05);绘制ROC曲线分析,FIGO分期、淋巴脉管间质浸润、SII、PNI均对患者术后生存预后有一定预测价值,曲线下面积分别为0.672、0.609、0.697、0.858。结论:FIGO分期ⅡA1~ⅡA2期、淋巴脉管间质浸润、SII高、PNI低与CC腹腔镜下根治术患者生存预后密切相关,且对预后不良有一定预测价值。

Objective:To explore the influencing factors of survival prognosis of patients with cervical cancer(CC)afterlaparoscopic radical.Methods:The clinicopathological data of 426 patients with CC who had been laparoscopic radicalresection from January 2014 to January 2019 were collected retrospectively.The 3-year overall survival rate of the pa-tients was counted,and the patients were divided into group A(patients with death)and group B(patients with sur-vival).The correlation between the demographic data,the complications situation,the pathological data,the laboratory examination data,and the postoperative adjuvant treatment data of the patients with CC after laparoscopic radicalresection and their survival prognosis was observed.Cox multivariate regression analysis was used to analyze the inde-Pendent factors of the patients affecting their survival prognosis.Receiver operating characteristic(ROC)curve wasdrawn to observe the predictive efficacy of the independent influencing factors of the patients for their survival progno-sis.Results:In the third year after operation,there were 426(93.7%)patients survived in group Band 27(6.3%)patients died in group A.The pathological type,the FIGO stage,the tumor diameter,the depth of invasion,the lympho-vascular interstitial infiltration,and the systemic immunoinflammatory index(SII)of the patients were all related totheir postoperative survival and prognosis.The FIGO stage of II A1-II A2,the lymphovascular interstitial infiltration,and the high SIl level of the patients with CC were all the independent risk factors of their postoperative survival andprognosis,but the high PNI level of the patients with CC was an independent protective factor(all P<0.05).ROCcurve analysis showed that the FIGO stage,the lymphovascular interstitial infiltration,and the SII and PNIlevels ofthe patients all had certain predictive values for their postoperative survival and prognosis,and the areas under thecurve of which were 0.672,0.609,0.697,and 0.858,respectively.Conclusion:The FIGO stage of II A1-II A2,the lymphovascular interstitial infiltration,and the high SII level and low PNIlevel of the patients with CC are closely re-lated to their survival prognosis afterlaparoscopic radical resection of CC,and allof which have certain predictive valuefor their poor prognosis.