Xie Xiu-Zhen, Song Kun, Cui Baoxia, Jiang Jie, Zhang You-Zhong, Wang Bo, Yang Xing-Sheng, Kong Bei-Hua
Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, China.
Asian Pac J Cancer Prev. 2012;13(11):5505-10. doi: 10.7314/apjcp.2012.13.11.5505.
The aim of this retrospective study is to analyze the clinical and pathological factors related to the prognosis of Chinese patients with stage Ib to IIb cervical cancer.
13 clinical pathological factors in 255 patients with stage Ib to IIb cervical cancer undergoing radical hysterectomy and systematic lymphadenectomy were analyzed to screen for factors related to prognosis. The cumulative 5-year survival of the 255 patients was 75.7%. The result of the univariate analysis suggested that clinical stage, cell differentiation, depth of cervical stromal invasion, parametrial tissue involvement, and lymph node metastasis were prognostic factors for patients with stage Ib to IIb cervical cancer (P<0.05). Compared with cases with involvement of iliac nodes, obturator nodes, or inguinal lymph nodes, cases with metastasis to the common iliac lymph nodes had a poorer prognosis (P<0.05). Cases with involvement of four or more lymph nodes had a poorer prognosis than those with involvement of three or fewer lymph nodes (P<0.05). Using multivariate Cox proportional hazards model regression analysis, non-squamous histological type, poor differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion were found to be independently related to patients poor prognosis (P<0.05).
Non-squamous histological type, poor cell differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion are the independent poor prognostic factors for patients with stage Ib to IIb cervical cancer.
本回顾性研究旨在分析与中国Ib至IIb期宫颈癌患者预后相关的临床和病理因素。
对255例接受根治性子宫切除术和系统性淋巴结清扫术的Ib至IIb期宫颈癌患者的13项临床病理因素进行分析,以筛选出与预后相关的因素。255例患者的5年累积生存率为75.7%。单因素分析结果显示,临床分期、细胞分化程度、宫颈间质浸润深度、宫旁组织受累情况及淋巴结转移是Ib至IIb期宫颈癌患者的预后因素(P<0.05)。与髂总淋巴结、闭孔淋巴结或腹股沟淋巴结受累的病例相比,髂总淋巴结转移的病例预后较差(P<0.05)。有4个或更多淋巴结受累的病例比有3个或更少淋巴结受累的病例预后更差(P<0.05)。采用多因素Cox比例风险模型回归分析发现,非鳞状组织学类型、低分化、宫旁组织受累及外1/3间质浸润与患者预后不良独立相关(P<0.05)。
非鳞状组织学类型、细胞低分化、宫旁组织受累及外1/3间质浸润是Ib至IIb期宫颈癌患者独立的预后不良因素。