子宫内膜癌术后化疗对阴道微生态的影响及与阴道残端感染关系分析

目的:探究子宫内膜癌初次手术后化疗对阴道微生态影响及其与阴道残端感染关系。方法:回顾性收集2012年1月-2013年3月本院术后化疗(观察组)及术后未化疗(对照组)的子宫内膜癌手术患者各64例临床资料。比较两组术前及术后6个月肿瘤标志物[糖类抗原125(CA125)、糖类抗原199(CA199)]、术后6个月阴道微生态和阴道残端感染状况,记录两组5年总生存率及无瘤生存率,使用Kaplan-Meier法绘制生存曲线,评估两组术后生存情况。结果:术后6个月时,两组血清CA125、CA199水平均较术前降低,且观察组低于对照组,阴道清洁度异常率(28.1%)、病原体感染率(20.3%)及阴道残端感染发生率(17.2%)均高于对照组(12.5%、7.8%、4.7%)(P<0.05)。术后5年时,观察组总生存率(90.6%)及无瘤生存率(81.3%)均高于对照组(76.6%、65.6%)(均P<0.05)。结论:子宫内膜癌初次手术后化疗可破坏阴道微生态平衡,并增加阴道残端感染风险,但化疗能控制远期复发转移,延长患者生存时间,于患者远期预后有利。提示临床化疗后应注意防控患者阴道微生态破坏。

Effect of chemotherapy on vaginal microecosystem of women after endometrial cancer surgery and its relationship with vaginal stump infection

Objective:To explore the effects of chemotherapy on the vaginal microecology of women after initial surgery of endometrial cancer,and to analyze its relationship with vaginal stump infection.Methods:The clinical data of 64 women with endometrial cancer surgical who had undergone postoperative chemotherapy(in observation group)and 64 women with endometrial cancer surgical who had not undergone postoperative chemotherapy(in control group)from January 2012 to March 2013 were retrospectively analyzed.The levels of tumor markers,such as carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),the situation of vaginal microecosystem,and the rate of vaginal stump infection of women before operation and 6 months after operation were compared between the two groups.The 5-year overall survival rate and tumor-free survival rate of women in the two groups were recorded.The survival curve drawn by Kaplan-Meier method was used for evaluating postoperative survival situation of women in the two groups.Results:6 months after operation,the serum levels of CA125 and CA199 had decrease significantly,and those of women in the observation group were significant lower than those of women in the control group(P<0.05).6 months after operation,the abnormal rate of vaginal cleanliness(28.1%),pathogen infection rate(20.3%)and incidence of vaginal stump infection(17.2%)of women in the observation group were all significant higher than those(12.5%,7.8%,and 4.7%)of women in the control group(P<0.05).5 years after surgery,the overall survival rate(90.6%)and the disease-free survival rate(81.3%)of women in the observation group were both significant higher than those(76.6%and 65.6%)of women in the control group(P<0.05).Conclusion:Chemotherapy after initial surgery of en dometrial cancer can destroy the vaginal micro-ecological balance and increase the risk of vaginal stump infection,but chemotherapy can control long-term recurrence and metastasis of endometrial cancer,and prolong the survival time,and it is benefit for the long-term prognosis of women with endometrial cancer.It suggests that the prevention and control of vaginal microecological damage after chemotherapy should be paid attention to in clinical practice.