宫颈微浸润腺癌（IA1 和 IA2）不良预后的危险因素：汇总分析。
Risk factors for poor prognosis in microinvasive adenocarcinoma of the uterine cervix (IA1 and IA2): a pooled analysis.
机构信息
Department of Obstetrics and Gynecology and Women's Health, Bronx, NY 10461, USA.
出版信息
Gynecol Oncol. 2011 Apr;121(1):135-42. doi: 10.1016/j.ygyno.2010.11.036. Epub 2010 Dec 30.
OBJECTIVE
To identify adverse risk factors for FIGO IA1 and IA2 cervical adenocarcinoma.
METHODS
PubMed was used to identify all microinvasive adenocarcinoma cases. Case specific data pooled for 35 "high risk" microinvasive adenocarcinoma (MIAC), defined as cases with lymph node or lymphovascular space involvement, positive surgical margins, or recurrence was compared with 478 "low risk" cases abstracted from the SEER database (1988-1997). Statistical methods included non-paired t and Fisher's Exact tests.
RESULTS
Survival for 1A1 and 1A2 MIAC is 99% and 98%, respectively. Significantly more 1A2 patients underwent aggressive radical surgery and received postoperative treatment. Parametrial involvement was rare (1/373 cases). Significantly more "high-risk" cases were of endometrioid histology (6/34 vs. 14/478, p=0.001), whereas adenocarcinoma (p=0.046) and mucinous (p=0.021) tumors were observed in the "low-risk" group. Among the "high-risk" cases with at least 5 years follow-up, 1.4% has recurred or died.
CONCLUSIONS
Endometrioid histology may be associated with late recurrence and worse survival in stage 1A1 and 1A2 MIAC.
目的
确定 FIGOIA1 和 IA2 宫颈腺癌的不良风险因素。
方法
利用 PubMed 数据库确定所有微浸润性腺癌病例。对 35 例“高危”微浸润性腺癌（MIAC）（定义为淋巴结或脉管间隙受累、手术切缘阳性或复发的病例）的特定病例数据进行汇总，并与 478 例从 SEER 数据库（1988-1997 年）中提取的“低危”病例进行比较。统计方法包括非配对 t 检验和 Fisher 确切检验。
结果
1A1 和 1A2 MIAC 的生存率分别为 99%和 98%。1A2 患者接受更积极的根治性手术和术后治疗的比例显著更高。宫旁受累罕见（373 例中 1 例）。更多的“高危”病例为子宫内膜样组织学（6/34 比 14/478，p=0.001），而低危组中观察到腺癌（p=0.046）和黏液腺癌（p=0.021）。在至少随访 5 年的“高危”病例中，有 1.4%出现复发或死亡。
结论
在 FIGOIA1 和 IA2 期 MIAC 中，子宫内膜样组织学可能与晚期复发和生存率降低有关。
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