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转移性宫颈癌中的脊髓压迫

Spinal cord compression in metastatic cervical cancer.

作者信息

Robinson W R, Muderspach L I

机构信息

Department of Obstetrics/Gynecology, LAC/USC Medical Center 90033.

出版信息

Gynecol Oncol. 1993 Feb;48(2):269-71. doi: 10.1006/gyno.1993.1046.

Abstract

Spinal cord compression secondary to metastatic cervical cancer may not be considered as a possible cause of neurologic symptoms by primary care physicians who do not often treat these patients. Delays in diagnosis and treatment may result in irreversible but potentially preventable neurologic changes. This report describes 5 cases of spinal cord compression in patients with metastatic cervical carcinoma, 2 of whom were previously undiagnosed with cervical cancer. These 2 patients represent 1.6% (2 of 121) of all new cervical cancer cases diagnosed during this time period. Two of 5 patients (40%) with spinal cord compression showed improvement following therapy by regaining the ability to walk, while none of the remaining patients had further acute deterioration of neurologic function. The mean survival of patients presenting with spinal cord compression from cervical cancer in this series was 4 months (maximum 6 months). This series illustrates the relative frequency with which spinal cord compression is seen in patients with a new diagnosis of invasive cancer. This diagnosis should be considered when evaluating neurologic complaints in known cervical cancer patients or any woman with apparent pelvic pathology. Rapid diagnosis and treatment of these lesions, while not likely to improve overall survival significantly, can improve function and alleviate symptoms.

摘要

对于不常诊治此类患者的基层医疗医生而言,转移性宫颈癌继发的脊髓压迫可能不会被视为神经症状的潜在病因。诊断和治疗的延迟可能导致不可逆转但有可能预防的神经功能改变。本报告描述了5例转移性宫颈癌患者发生脊髓压迫的病例,其中2例此前未被诊断出患有宫颈癌。这2例患者占该时间段内所有新诊断宫颈癌病例的1.6%(121例中的2例)。5例脊髓压迫患者中有2例(40%)在接受治疗后症状改善,恢复了行走能力,而其余患者均未出现神经功能的进一步急性恶化。本系列中出现脊髓压迫的宫颈癌患者的平均生存期为4个月(最长6个月)。本系列病例说明了新诊断为浸润性癌的患者中脊髓压迫的相对发生率。在评估已知宫颈癌患者或任何有明显盆腔病变的女性的神经症状时,应考虑这一诊断。对这些病变进行快速诊断和治疗,虽不太可能显著提高总体生存率,但可改善功能并缓解症状。

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