摘要
目的探讨宫颈腺癌的临床特点,并分析患者生存状况及相关预后因素。方法回顾性分析2013年1月至2022年10月在宁夏医科大学总医院就诊且明确病理诊断的229例宫颈腺癌患者的资料。其中,198例早期患者的治疗方法以手术为主,31例局部进展期患者的治疗方法以放化疗为主。计算全组患者及不同治疗方法亚组患者的总生存(OS)率和无进展生存(PFS)率。采用Kaplan-Meier法和log-rank检验进行生存分析,采用Cox比例风险模型,对生存影响因素进行单因素、多因素分析。结果229例宫颈腺癌患者的病理分类有11种,以普通型腺癌为主,截至随访期末共有复发转移患者57例(24.9%)。全组3、5年OS率分别为86.4%、79.3%,3、5年PFS率分别为81.6%和73.6%。多因素分析显示,国际妇产科协会(FIGO)分期为Ⅲ~Ⅳ期是OS和PFS的独立预后因素(HR=2.033,95%CI为1.456~2.839,P<0.001;HR=1.701,95%CI为1.251~2.313,P=0.001),有淋巴结转移是PFS的独立危险因素(HR=1.610,95%CI为1.021~2.539,P=0.041)。手术治疗为主的198例患者的亚组分析:3、5年OS率分别为90.0%、84.9%,3年、5年PFS率分别为82.7%、76.7%。多因素分析显示,有淋巴结转移、浸润深度较深是OS(HR=6.893,95%CI为2.592~18.327,P<0.001;HR=1.952,95%CI为1.164~3.272,P=0.011)和PFS(HR=5.507,95%CI为2.569~11.805,P<0.001;HR=1.638,95%CI为1.09~2.461,P=0.018)的独立预后因素。保留卵巢是PFS的独立危险因素(HR=3.364,95%CI为1.115~10.151,P=0.031)。结论宫颈腺癌病理类型复杂多样。局部复发和远处转移是治疗失败的主要原因。FIGO分期、淋巴结转移、术后浸润深度是宫颈腺癌的主要预后因素。
Objective To investigate the clinical characteristics of cervical adenocarcinoma and analyze the survival status and related prognostic factors.Methods The data of 229 patients with cervical adenocarcinoma who were diagnosed pathologically in the General Hospital of Ningxia Medical University from January 2013 to October 2022 were retrospectively analyzed.Among them,198 early stage patients were mainly treated with surgery,and 31 locally advanced stage patients were mainly treated with chemoradiotherapy.The overall survival(OS)and progression-free survival(PFS)rates in the whole cohort of patients and different treatment subgroups were calculated.Kaplan-Meier method and log-rank test were used for survival analysis,and Cox proportional hazards model was used for univariate and multivariate survival analyses.Results Among the 229 patients,there were 11 subtypes of pathological classifications,predominantly of the usual-type.At the end of follow-up,57 patients(24.9%)relapsed.The 3-and 5-year OS rates were 86.4%and 79.3%,respectively,and the 3-and 5-year PFS rates were 81.6%and 73.6%,respectively.Multivariate analysis showed that International Federation of Gynecology and Obstetrics(FIGO)staging of stagesⅢ-Ⅳwas an independent prognostic factor for OS and PFS(HR=2.033,95%CI=1.456-2.839,P<0.001;HR=1.701,95%CI=1.251-2.313,P=0.001).Lymph node metastasis was an independent risk factor for PFS(HR=1.610,95%CI=1.021-2.539,P=0.041).Subgroup analysis of 198 patients with surgical treatment:the 3-and 5-year OS rates were 90.0%and 84.9%,and the 3-and 5-year PFS rates were 82.7%and 76.7%,respectively.Multivariate analysis showed that lymph node metastasis and deep invasion depth were the main risk factors for OS(HR=6.893,95%CI=2.592-18.327,P<0.001;HR=1.952,95%CI=1.164-3.272,P=0.011)and PFS(HR=5.507,95%CI=2.569-11.805,P<0.001;HR=1.638,95%CI=1.09-2.461,P=0.018).Ovarian preservation was an independent risk factor for PFS(HR=3.364,95%CI=1.115-10.151,P=0.031).Conclusions The pathological types of cervical adenocarcinoma are complex and diverse.Local recurrence and distant metastasis are the main reasons for treatment failure.FIGO stage,lymph node metastasis and postoperative depth of invasion are the main prognostic factors of cervical adenocarcinoma.
作者
陆青
潘闻燕
拜周兰
杨燕
唐静
孟颖
陆海洋
冯阳阳
马建萍
Lu Qing;Pan Wenyan;Bai Zhoulan;Yang Yan;Tang Jing;Meng Ying;Lu Haiyang;Feng Yangyang;Ma Jianping(Department of Radiation Oncology,Tumor Hospital and General Hospital of Ningxia Medical University,Yinchuan 750004,China)
出处
《中华放射肿瘤学杂志》
北大核心
2025年第8期790-795,共6页
Chinese Journal of Radiation Oncology
关键词
宫颈肿瘤
腺癌
手术
放化疗法
预后因素
Uterine cervical neoplasms,adenocarcinoma
Operation
Chemoradiotherapy
Prognosis factors
