宫颈腺癌125例预后分析

【目的】 总结宫颈腺癌临床病理资料和随访资料,了解宫颈腺癌预后相关因素? 【方法】 回顾性分析中山大学附属第一医院妇科2000 年1 月至2010 年12 月间收治的125 例宫颈腺癌临床病理资料和随访资料?【结果】 125例患者中位年龄45 岁, 总的5 年生存率为75.5%, 按FIGO 分期Ⅰ?Ⅱ?Ⅲ期患者5年生存率分别为93.4%?66.7%?30.0%?单因素?多因素分析均显示FIGO分期?局部肿瘤大小?组织学分级是影响预后的独立因素?39例II期患者采用不同方法治疗的预后差异无统计学意义(P = 0.122)?102例手术治疗患者,63例行双附件切除,卵巢转移4例,其中ⅡB期1例,Ⅲ期3例;39例保留单侧或双侧卵巢患者随访中,2例发生卵巢转移,本组经病理确诊的卵巢转移率为5.9%(6/102)?卵巢保留与否者的5年生存率无统计学差异(P > 0.05)?本组25例临床检查宫颈外观正常者宫颈液基细胞学检查20例(80%)异常,5例(20%)正常?【结论】 FIGO分期晚?局部肿瘤直径 > 4 cm?肿瘤细胞分化差的患者预后较差?根治性手术或以根治性手术为主的综合治疗是治疗宫颈腺癌的主要方法,早期年轻宫颈腺癌患者可考虑保留卵巢功能?宫颈液基细胞学检查有助于无症状体征宫颈腺癌患者的早期诊断?

Clinical Analysis of 125 Cases of Cervical Adenocarcinoma

【Objective】 To investigate the prognosis of cervical adenocarcinoma by analyzing the clinical and follow-up data.【Methods】 Clinical and pathological data of 125 cases of cervical adenocarcinoma hospitalized in Department of Obstetrics and Gynecology of the First Affiliated Hospital of Sun Yat-san University from January 2000 to October 2010 were retrospectively analyzed. 【Results】 Median age of these cases was 45 years. According to FIGO staging system, the overall 5-year survival rate was 75.5%, and it was 93.4%, 66.7%, and 30.0% for stages Ⅰ, Ⅱ, and Ⅲ, respectively. The FIGO stages, carcinoma diameter, and grading of tumor were independent factors of the survival rate for cervical adenocarcinoma patients. The prognosis of 39 cases at stages Ⅱ who received different treatments were not statistically significant (P = 0.122). In the 102 surgery cases, 63 cases received bilateral accessories resection, 4 cases suffered from ovarian metastasis, and one of those was of stage ⅡB, three of those were of stage Ⅲ. However, in the 39 surgery cases preserving ovarian function, 2 cases suffered from ovarian metastasis in the work of follow-up. In this study, proportion of ovarian metastasis with pathological diagnosis was 5.9% (6/102). In the surgery patients, whether preserving ovarian function were not statistically significant (P > 0.05). 25 cases with apparently normal cervix uteri received liquid based cytology test and 80% of these cases presented pathological changes.【Conclusions】 Patients with late FIGO stages, carcinoma diameter over 4 cm and poorly differentiation had worse prognosis. Radical hysterectomy and comprehensive therapy involving radical hysterectomy were the main treatments of cervical adenocarcinoma, preserving ovarian function could be applied in young women with early stages. Liquid based cytology test was conducive to early diagnosis of cervical adenocarcinoma with nonspecific signs and symptoms.