Ⅰb-Ⅱb期手术治疗的宫颈腺癌卵巢转移及预后分析

Ovarian metastasis and prognostic factors of stageⅠb-Ⅱb cervical adenocarcinoma with surgery as primary treatment

目的 探讨Ⅰb—Ⅱb期手术治疗的宫颈腺癌卵巢转移的高危因素 ,并分析预后因素。方法 回顾性研究 32例Ⅰb—Ⅱb期手术治疗的宫颈腺癌的临床病理特点 ,应用 χ2 检验及logistic回归分析探讨 4例卵巢转移的高危因素 ;应用Kaplan -Meier法及Cox回归模型分析预后因素。结果 单因素分析提示卵巢转移的高危因素是临床分期和盆腔淋巴结转移 ,但多因素分析没有发现有统计学意义的危险因素。Cox回归提示肿瘤大小和盆腔淋巴结转移是独立预后因素。结论 对于有高危因素的宫颈腺癌 ,术中保留卵巢需要慎重。

ObjectiveTo investigate the incidence and high-risk factors of ovarian metastasis in stageⅠb-Ⅱb cervical adenocarcinoma with surgery as primary treatment and to examine the prognostic factors. MethodsClinical and pathological variables of 32 stageⅠb-Ⅱb cervical adenocarcinoma with surgery as primary treatment were studied, the risk factors of ovarian metastasis were revealed by means of χ 2 test and logistic regression analysis , and the significant prognostic factors were indicated by means of Kaplan-Meier method and Cox model. ResultsOvarian metastasis was identified in 4 of 32 ( 12.5% ) patients. It was indicated that clinical stage and pelvic lymph node metastasis were risk factors by χ 2 test ,whereas the logistic regression analysis indicated these factors were non-independent factors. It was demonstrated that size of tumors and pelvic lymph node metastasis were significant prognostic factors by Cox model. ConclusionSufficient attention should be paid to reserved ovary in the radical hysterectomy for cervical adenocarcinoma with risk factors of ovarian metastasis.