Kang Yaxin, Chang Lele, Liu Jing, Ji Haizhou, Xu Qin
Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China.
Departments of Gynecology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, Fujian Province, China.
Cancer Med. 2025 May;14(9):e70927. doi: 10.1002/cam4.70927.
There is significant histological heterogeneity between the endocervical adenocarcinoma (EA) subtypes. Usual-type carcinoma (adenocarcinoma) and mucinous carcinoma (mucinous adenocarcinoma, MA) are the most common types of EA.
Demographic and clinical variables were collected from the SEER database for selected patients between 2004 and 2021. The effect of confounding variables was reduced by propensity score matching (PSM). Survival data were analyzed using the Kaplan-Meier method and Cox regression models. A risk prediction model nomogram for MA was developed and validated.
The median age for MA patients was 46 years compared to 45 years for adenocarcinoma (p = 0.021). The 1-, 3-, and 5-year overall survival (OS) rates for MA were 88.2%, 74.5%, and 68.4%, respectively, significantly lower than those for adenocarcinoma (89.0%, 79.0%, and 74.9%, p < 0.0001). Cancer-specific survival (CSS) showed a similar trend (p < 0.0001). Seven variables, including age, primary site, T, N, combined stage, surgery, and chemotherapy, were selected to create the nomograms for predicting OS, while age, primary site, tumor size, T, N, combined stage, and surgery were selected for CSS. The validations of all predictive models were satisfactory.
This study revealed MA's poorer prognosis compared to adenocarcinoma using the SEER database. It developed predictive models for OS and CSS of MA, offering a more accurate prognosis assessment tool for clinical practice.
宫颈管腺癌（EA）各亚型之间存在显著的组织学异质性。普通型癌（腺癌）和黏液癌（黏液腺癌，MA）是EA最常见的类型。
从监测、流行病学与最终结果（SEER）数据库收集了2004年至2021年选定患者的人口统计学和临床变量。通过倾向评分匹配（PSM）减少混杂变量的影响。使用Kaplan-Meier方法和Cox回归模型分析生存数据。开发并验证了MA的风险预测模型列线图。
MA患者的中位年龄为46岁，而腺癌患者为45岁（p = 0.021）。MA的1年、3年和5年总生存率（OS）分别为88.2%、74.5%和68.4%，显著低于腺癌（89.0%、79.0%和74.9%，p < 0.0001）。癌症特异性生存率（CSS）呈现类似趋势（p < 0.0001）。选择年龄、原发部位、T、N、综合分期、手术和化疗等7个变量来创建预测OS的列线图，而选择年龄、原发部位、肿瘤大小、T、N、综合分期和手术来预测CSS。所有预测模型的验证结果均令人满意。
本研究利用SEER数据库揭示了MA与腺癌相比预后较差。它开发了MA的OS和CSS预测模型，为临床实践提供了更准确的预后评估工具。
