宫颈癌患者术后复发的病理特点及5年内复发的影响因素

Pathological characteristics of postoperative recurrence and influencing factors of recurrence within 5 years in cervical cancer patients

关键词:  Ⅰa 2~Ⅱa 2 期  宫颈癌  复发  病理特点  5 年无复发生存  影响因素

Key words:  stage Ia 2-IIa 2  cervical cancer  recurrence  pathological characteristics  5-year recurrence free survival  influence factor

摘要:

目的 探讨Ⅰa2～Ⅱa2期宫颈癌患者术后复发的病理特点及5年内复发的影响因素。方法 回顾性分析2015年1月至2018年7月在湛江中心人民医院医治的375例Ⅰa2～Ⅱa2期宫颈癌患者的临床资料。分析Ⅰa2～Ⅱa2期宫颈癌患者术后复发的病理特点。根据是否5年复发将患者分为5年无复发生存（DFS）组和复发组。采用多因素logistic回归分析5年内复发的影响因素。结果 375例患者5年内复发率为14.7%。5年DFS率为85.3%。在复发的病例中，Ⅱa2期22例（40.0%）、低分化型38例（69.1%）、内生型病灶39例（70.9%）、鳞癌37例（67.3%）。Ⅱa期宫颈癌、低分化型宫颈癌、肿瘤直径≥4 cm、宫颈浸润深度>1/2肌层是5年内复发的独立危险因素。结论 Ⅱa期宫颈癌、低分化型宫颈癌、肿瘤≥4 cm、宫颈浸润深度>1/2肌层的Ⅰa2～Ⅱa2期宫颈癌患者容易在5年内复发。

Abstract:

Abstract: Objective To investigate the pathological characteristics of postoperative recurrence and the influencing factors of recurrence within 5 years in stage Ia 2-IIa 2 cervical cancer patients. Methods Retrospective analysis was performed on clinical data of 375 patients with stage Ia 2-IIa 2 cervical cancer treated in the People’s Hospital of Zhanjiang Center from January 2015 to July 2018. The pathological characteristics of postoperative recurrence in stage Ia 2-IIa 2 cervical cancer patients were analyzed. Patients were divided into 5-year recurrence free survival (DFS) group and a recurrence group based on 5-year recurrence data. The influencing factors of recurrence within 5 years were determined by using multivariate logistic regression analysis. Results The 5-year DFS rate was 85.3%. Among the recurrent cases, there were 22 cases (40.0%) of stage IIa 2, 38 cases (69.1%) of poorly differentiated type, 39 cases (70.9%) of endogenous type lesions, and 37 cases (67.3%) of squamous cell carcinoma. Stage IIa cervical cancer, poorly differentiated cervical cancer, tumors≥4 cm, and cervical infiltration depth>1/2 of the myometrium were independent risk factors for recurrence within 5 years. Conclusion Patients with stage IIa cervical cancer, poorly differentiated cervical cancer, tumors greater than 4 cm, and cervical infiltration depth greater than 1/2 of the myometrium in stage Ia 2-IIa 2 cervical cancer are prone to recurrence within 5 years.