Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Am J Obstet Gynecol. 2012 Jan;206(1):80.e1-6. doi: 10.1016/j.ajog.2011.07.029. Epub 2011 Jul 22.
We compared the outcomes of microinvasive squamous cell carcinoma and adenocarcinoma of the cervix and examined the safety of fertility-conserving treatment.
The Surveillance, Epidemiology, and End Results database was used to identify all women with stage IA1 and IA2 cervical carcinoma diagnosed from 1988 to 2005. The treatment and outcomes of women with adenocarcinomas were compared with squamous cell carcinomas.
A total of 3987 women including 988 with adenocarcinomas (24.8%) were identified. Women with adenocarcinoma were more often white and were younger (P < .05 for all). Survival for stage IA1 adenocarcinomas (hazard ratio, 0.79; 95% confidence interval, 0.21-2.94) was similar to that of women with squamous cell tumors. For stage IA2 tumors, survival was similar for squamous cell and adenocarcinomas (hazard ratio, 0.51; 95% confidence interval, 0.18-1.47). For stage IA1 and IA2 adenocarcinomas, survival was similar for conization and hysterectomy.
Survival is similar for microinvasive adenocarcinomas and squamous cell carcinomas. Conization appears to be adequate treatment for microinvasive adenocarcinoma.
我们比较了宫颈微浸润鳞癌和腺癌的结局，并探讨了保留生育力治疗的安全性。
我们使用监测、流行病学和最终结果数据库，确定了 1988 年至 2005 年间诊断为 IA1 期和 IA2 期宫颈癌的所有女性。比较了腺癌和鳞癌患者的治疗和结局。
共纳入 3987 例女性，包括 988 例腺癌（24.8%）。腺癌患者白人居多，且年龄更小（所有 P <.05）。IA1 期腺癌的生存情况（风险比为 0.79；95%置信区间为 0.21-2.94）与鳞癌患者相似。IA2 期肿瘤中，鳞癌和腺癌的生存情况相似（风险比为 0.51；95%置信区间为 0.18-1.47）。IA1 期和 IA2 期腺癌患者，锥切术和子宫切除术的生存情况相似。
微浸润腺癌和鳞癌的生存情况相似。对于微浸润腺癌，锥切术似乎是一种足够的治疗方法。
