摘要
目的：探讨宫颈癌远处转移的发生率、危险期、好发部位、治疗疗效及影响远处转移时间的高危因素。方法：回顾性分析2000-04-01-2011-10-31我院收治的892例宫颈癌患者中发生远处转移的37例患者的临床资料。结果：宫颈癌远处转移发生率为4.1%（37/892）;远处转移的发生时间大都在治疗开始2年内,占73%（27/37）;远处转移部位以远处淋巴结居多（除外盆腔内淋巴结）,占51.4%（19/37）,肺占37.8%（14/37）、骨占24.3%（9/37）、肝及其他部位占24.3%（9/37）。宫颈癌患者盆腔复发率为11.9%（106/892）,其远处转移患者中伴盆腔复发为78.4%（29/37）,单纯盆腔复发患者的同步放化疗2年生存率较远处转移患者高,χ2=22.471,P=0.000。宫颈癌远处转移时间的危险因素：高分化患者发生远处转移的时间明显长于低、中分化,P值分别为0.000和0.001;但是中分化与低分化患者发生远处转移的时间差异无统计学意义,P=0.240。〈60岁的患者发生远处转移的时间均明显早于〉60岁的患者,P值分别为0.002和0.001;但是〈60岁的患者中,〈40岁与40~60岁的患者发生远处转移的时间差异无统计学意义,P=0.956。ⅠB与ⅡA,ⅡA与ⅡB,Ⅲ与Ⅳ期患者发生远处转移的时间差异均无统计学意义,P值分别为0.706、0.051和0.695;但是ⅡB期发生远处转移时间明显晚于Ⅲ、Ⅳ期,P值分别为0.021和0.013。结论：子宫颈癌远处转移大都出现在治疗开始2年内,以淋巴结、肺等为主要转移部位且治疗疗效较差,分化差、分期晚的年轻患者更易出现远处转移,提示出临床上应加强易发宫颈癌远处转移的高危人群的监测和随访。
OBJECTIVE：To explore the predilection sites,crises and high-risk factors for cervical carcinoma with distant metastasis.METHODS：Screening 37cases of cervical cancer patients with distant metastasis from 892patients for retrospective analysis.RESULTS：The incidence of cervical cancer patients with distant metastasis accounted for 4.1%（37/892）and they mostly occurred within 2years after the start of treatment,and the most predilection site was lymph nodes which accounted for 51.4%（19/37）except the pelvic lymph nodes,the remaining parts were the lung 37.8%（14/37）,bone24.3%（9/37）,liver and others 24.3%（9/37）.The rate of cervical cancer patients with pelvic recurrence was 11.9%（106/892）.There were 78.4%（29/37）cervical cancer patients with distant metastases including pelvic recurrence.Two-year survival rate of concurrent chemoradiotherapy for cervical cancer patients with pelvic recurrence was much better than that of distant metastases（χ2=22.471;P=0.000）.The effection of risk facrors for distant metastasis time：The time of well-differentiated cervical cancer patients with distant metastasis was significantly longer than that of the low grade cases（P=0.000;P=0.001）,but there was no significant difference in the low differentiation of cervical cancer（P=0.240）.The time of distant metastasis in younger patients occurred significantly earlier than that of older than60-year-old ones（P=0.002;P=0.001）,but no significant difference was found between the less than 40-year-old patients and the among 40-60year-old ones（P=0.956）.The comparison between the time of cervical cancer with distant metastasis and the staging of cervical cancer showed that there were no significant differences between the groups of phaseⅠB and phaseⅡA,phaseⅡA and phaseⅡB,phaseⅢand phaseⅣ（P=0.706;P=0.051;P=0.695）,but the time of phaseⅡb of cervical cancer with distant metastasis occurred significantly later than that of phaseⅢ and phaseⅣ of cervical cancer（P=0.021;P=0.013）.CONCLUSIONS：The patients of cervical cancer with distant metastasis mostly occurs within 2years after the start of treatment.The mainly metastatic sites are lymph nodes and lung and the treatment efficacy was usually poor.Poorly differentiated and late stage younger patients were more likely to have distant metastases.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2013年第19期1522-1524,共3页
Chinese Journal of Cancer Prevention and Treatment
关键词
宫颈肿瘤
病理学
远处转移
高危因素
回顾性研究
cervical neoplasms/pathology distant metastasis risk factor retrospective studies
