35例宫颈腺鳞癌临床分析

目的:分析宫颈腺鳞癌患者的临床特点、治疗方式。比较不同期别、不同组织分级患者的生存情况。方法:回顾性分析35例宫颈腺鳞癌患者的临床资料。结果:35例患者中位年龄45岁,均以阴道异常出血为首发临床症状。14例ⅠB1期～ⅡA期患者中,有2例ⅡA期患者接受了单纯放疗,另外12例接受了手术治疗,其中2例术后接受了化疗,2例术后接受了单纯放疗,2例术后接受了同步放化疗,其余6例术后未接受辅助治疗。18例ⅡB期～ⅢB期患者中9例接受了单纯放疗,9例接受了同步放化疗。3例Ⅳ期患者均接受了化疗+姑息性放疗。共有10例患者肿瘤复发,复发率为28.6%。中位复发时间为4.5个月。所有患者的3年和5年生存率分别为85.7%和78.0%。Ⅰ、Ⅱ和Ⅲ期患者的5年生存率分别为100%,93.3%和56.3%,3例Ⅳ期患者的生存时间分别为2、10和15个月。高、中分化患者的5年生存率为93.3%,低分化患者的5年生存率为66.9%,但无显著差异(P=0.208)。结论:宫颈腺鳞癌早期患者可以手术治疗或同步放化疗,预后较好。晚期患者应予同步放化疗,预后相对较差,特别是Ⅳ期患者,预后极差。

Clinical analysis of 35 eases of adenosqumous carcinoma of the cervix

Objective:To evaluate the clinical characteristics and treatment method of adenosquamous carcinoma of cervix and compare the survival of different stage and grade.Methods:35 patients with adenosquamous carcinoma of cervix treated at the Cancer Hospital,PUMC,CAMS were retrospectively analyzed.Results:The median age of the 35 patients was 45.First clinical symptom was abnormal vaginal bleeding in all cases.Two stage ⅡA patients received only radiotherapy.The other 12 patients received surgery.Two of them received chemotherapy post surgery.Two of them received only radiotherapy post surgery and two of them received radiotherapy and concurrent chemotherapy post surgery.The left six patients received no treatment post surgery.Nine of eighteen stage ⅡB to ⅢB patients received only radiotherapy and the other nine received radiotherapy and concurrent chemotherapy.Three stage Ⅳ patients received chemotherapy and palliative radiotherapy.Ten of thirty-five(28.6%) patients had recurrence and the median time to recurrence was 4.5 months.The 3-year and 5-year survival rate were 85.7% and 78.0%.The 5-year survival rates of stage Ⅰ,Ⅱ and Ⅲ were 100%,93.3% and 56.3% respectively.The survival time of three stage Ⅳ patients were 2 months,10 months and 15 months respectively.The 5-year survival rates of grade 1,2 and grade 3 patients were 93.3% and 66.9%,but there was no significant difference between them.Conclusion:Early stage adenosquamous carcinoma of the cervix patients can be treated with surgery or radiotherapy with concurrent chemotherapy.They have good prognosis.Advanced stage patients should be treated with radiotherapy with concurrent chemotherapy.They have worse prognosis,especially stage Ⅳ patients.