Chen Xin, Zhang Guonan
Department of Clinical Medicine, Luzhou Medical College, Luzhou 646000, China.
610041 Chengdu, Department of Gynecologic Oncology, Sichuan Cancer Hospital. Email:
Zhonghua Fu Chan Ke Za Zhi. 2014 Mar;49(3):208-12.
To evaluate the clinical significance of changes in peripheral lymphocyte count after surgery in early cervical cancer.
The 123 patients with stage Ib1 and IIa1 treated by abdominal type III radical hysterectomy from May 2008 to December 2012 were reviewed. The median age of patients was 43 years old (range: 30 to 66 years). The median follow-up was 25 months with a range of 5-61 months. Peripheral blood samples were obtained on pre-operative, post-operation day 3 and 7. The log-rank test was used to compare the homogeneity of progression-free survival functions across strata defined by categories of prognostic variables. The Cox proportional hazard model was used to assess the significance of potential prognostic factors for progression-free survival.
Univariate analyses preoperative lymphocyte count (P = 0.012) and lymph nodes metastases status (P = 0.001) and parametrial invasion (P = 0.013) were significant risk factors for progression-free survival rate. On multivariate analyses, preoperative lymphocyte count [hazard ratio (HR) = 6.087, 95%CI: 1.743-21.251, P = 0.005] and lymph nodes metastases status (HR = 5.984, 95%CI: 1.803-19.802, P = 0.003) were independent risk factor of progression-free survival rate.
Peripheral lymphocyte counts after cervical cancer surgery may be a important prognostic factor.
评估早期宫颈癌术后外周血淋巴细胞计数变化的临床意义。
回顾性分析2008年5月至2012年12月期间接受腹式III型根治性子宫切除术治疗的123例Ib1期和IIa1期患者。患者中位年龄为43岁(范围:30至66岁)。中位随访时间为25个月,范围为5至61个月。于术前、术后第3天和第7天采集外周血样本。采用对数秩检验比较由预后变量类别定义的各层无进展生存函数的同质性。采用Cox比例风险模型评估无进展生存潜在预后因素的显著性。
单因素分析显示术前淋巴细胞计数(P = 0.012)、淋巴结转移状态(P = 0.001)和宫旁浸润(P = 0.013)是无进展生存率的显著危险因素。多因素分析显示,术前淋巴细胞计数[风险比(HR)= 6.087,95%可信区间:1.743 - 21.251, P = 0.005]和淋巴结转移状态(HR = 5.984,95%可信区间:1.803 - 19.802, P = 0.003)是无进展生存率的独立危险因素。
宫颈癌术后外周血淋巴细胞计数可能是一个重要的预后因素。