中国女性宫颈鳞癌与腺癌生物学行为比较的系统评价

目的：探讨宫颈鳞癌（SCC）和宫颈腺癌（AC）在生物学行为方面存在的差异,为宫颈癌的合理诊治提供循证依据.方法：利用Meta分析的方法综合评价国内公开发表的所有关于SCC和AC的相关文献,最终符合入选标准的文献共5篇,包含2151例患者,宫颈鳞癌1675例、宫颈腺癌476例.采用RevMan5.1软件进行统计分析,评价指标：肿瘤生长方式、FIGO分期、分化程度、淋巴 结转移、卵巢转移及宫旁浸润.结果：Meta分析结果显示：宫颈鳞癌肉眼观呈溃疡型所占比例明显高于腺癌 患者（RR=1.96,95%CI：0.99-3.90,P=0.047）,而内生型所占比例明显低于腺癌患者（RR=0.50,95%CI：0.32-0.78,P=0.002）;宫颈鳞癌和腺癌FIGO分期和总体分化程度差异无统计学意义（P均大于0.05）;宫颈腺癌淋巴结转移和卵巢转移都明显高于鳞癌患者（RR=0.56,95%CI：0.35-0.90,P=0.02）,（RR=0.17,95%CI：0.07-0.44,P=0.0002）;宫颈鳞癌和腺癌宫旁浸润差异无统计学意义（P＞0.05）.结论：宫颈鳞癌与腺癌肿瘤生长方式存在差异;宫颈腺癌淋巴结转移和卵巢转移都明显高于鳞癌患者;宫颈鳞癌和腺癌FIGO分期,总体分化程度,宫旁浸润无明显差异.

Comparison of the biological behaviors and prognosis in cervical adenocarcinoma and squamous carcinoma in China-System evaluation

Objective：To investigate the difference of biological behaviors between cervical adenocarcinonma and squamous cervical cancer, and provide reasonable evidence- based basis. Methods：Synthetically assessed the litera- tures about squamous cervical cancer（SCC） and cervical adenocarcinoma（AC） by meta analysis. Finally,5 literatures including 2151 patients were according with standard. Among them 1675 patients with SCC and 476 patients with AC. RevMan 5.1 was used for Meta - analysis. The evaluation parameters included growth way of tumor,FiGO stage,total differentiation,lymph node metastasis, ovarian metastasis ,iterine side metastasis. Results ： The proportion of ulceration was obviously higher in SCC than that in AC（RR=1.96,95%CI：0.99 -3.90,P=0.047） ,while the proportion of endogeny was obviously lower in SCC （RR=0.50,95% CI：0.32 - 0.78,P=0. 002）. There were no significant differ- ences in FIGO stage, uterine side metastasis and total differentiation（P 〉 0.05） ;The lymph node metastasis and ovar- ian metastasis were higher in AC（RR=0.56,95%CI：0.35-0.90,P=0.02）,（RR 0.17,95%CI：0.07-0.44,P=0. 0002）. Conclusion：There was difference in growth way of SCC and AC. The lymph node metastasis and ovarian metastasis were higher in AC. There were no significant differences in FIGO stage, uterine side metastasis and total differentiation.