宫颈粘液腺癌25例临床分析

Clinical Analysis of 25 Cases of Cervical Mucinous Adenocarcinoma

目的 探讨宫颈粘液腺癌诊断、治疗及影响预后的有关因素。方法 回顾分析 2 5例宫颈粘液腺癌的临床资料。结果 6例曾出现 3～ 6个月的误诊。Ⅰ期、Ⅱ期病例以手术治疗为主 ;Ⅲ期、Ⅳ期病例以放射治疗为主。全组 5年生存率 32 %。手术治疗 5年生存率为 5 3% ,盆腔淋巴结阳性 5年生存率 2 5 % ,阴性 78% (P <0 0 5 ) ;放射治疗 5年生存率为 14 %。治疗后复发部位主要在盆腔和阴道。结论 对临床可疑病例可行宫颈多部位及较深部组织活检或切取活检 ,以提高阳性率。宫颈粘液腺癌预后较差。早期病例应采用以手术为主的综合治疗。早期诊断和采用综合治疗可望提高

Objective To explore the diagnosis,therapy and prognostic factors of cervical mucinous adenocarcinoma.Methods Clinical data of 25 patients with cervical mucinous adenocarcioma were analyzed retrospectively.Results Misdiagnosis happened in 6 cases.Patients with stage Ⅰ and Ⅱ were treated mainly by surgery;Patients with stage Ⅲ and Ⅳ were treated mainly by radiotherapy.Overall 5-year survival rate was 32%.5-year survival rate of surgery and radiotherapy was 53% and 14% respectively,and 5 year survival rate of patients with and without lymphnode involvement were 25% and 78% respectively (P<0.05).The sites of recurrence were mainly in pelvic cavity and vagina.Conclusion To increase the positive rate,multiple and deep site biopsy or incisional biopsy can be made in clinically suspicious patients.Prognosis of cervical mucinous adenocarcinoma is poor.Combined therapy including surgery should be used in patients of early stage.Early diagnosis and combined therapy are of expectation to improve 5-year survival rate.