张静雅, 古力米热·布然江, 涂剑楠, 金华. Ⅰb~Ⅱa期宫颈癌术后放疗后复发的相关因素分析[J]. 中国肿瘤临床, 2018, 45(20): 1062-1065. DOI: 10.3969/j.issn.1000-8179.2018.20.752
引用本文: 张静雅, 古力米热·布然江, 涂剑楠, 金华. Ⅰb~Ⅱa期宫颈癌术后放疗后复发的相关因素分析[J]. 中国肿瘤临床, 2018, 45(20): 1062-1065. DOI: 10.3969/j.issn.1000-8179.2018.20.752
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Zhang Jingya, Mihrigul·Buranjiang, Tu Jiannan, Jin Hua. Analysis of recurrence factors for stage Ⅰb-Ⅱa cervical cancer after postoperative radiotherapy[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2018, 45(20): 1062-1065. DOI: 10.3969/j.issn.1000-8179.2018.20.752
Citation: Zhang Jingya, Mihrigul·Buranjiang, Tu Jiannan, Jin Hua. Analysis of recurrence factors for stage Ⅰb-Ⅱa cervical cancer after postoperative radiotherapy[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2018, 45(20): 1062-1065. DOI: 10.3969/j.issn.1000-8179.2018.20.752
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Ⅰb~Ⅱa期宫颈癌术后放疗后复发的相关因素分析

Analysis of recurrence factors for stage Ⅰb-Ⅱa cervical cancer after postoperative radiotherapy

    摘要
  • 摘要:
      目的  探讨影响Ⅰb~Ⅱa期宫颈癌术后放疗后复发的相关因素，为宫颈癌术后放疗后复发的预防及个性化综合治疗提供依据。
      方法  回顾性分析2010年1月至2015年4月193例于新疆医科大学附属肿瘤医院诊断并接受规范治疗的Ⅰb~Ⅱa期宫颈癌患者的临床病理资料，分为术后放疗后复发组36例和未复发组157例，并对患者术后放疗后复发的相关因素进行分析。
      结果  193例宫颈癌患者中鳞癌、腺癌、其他病理类型的发病率分别为90.2%(174/193)、5.7%(11/193)、4.1%(8/193)。鳞癌、腺癌及其他病理类型宫颈癌的复发率分别为16.7%(29/174)、45.5%(5/11)、25.0%(2/8)，比较不同病理类型宫颈癌的复发率，差异具有统计学意义(χ2=12.463，P < 0.05)。复发组年龄≤40岁、腺癌、阴道切缘阳性、有脉管浸润、淋巴结转移、有宫旁受侵的构成比高于未复发组，两组进行比较差异具有统计学意义(P < 0.05)。阴道切缘阳性、有脉管浸润、有宫旁受侵是宫颈癌术后放疗后复发的独立危险因素。
      结论  Ⅰb~Ⅱa期宫颈癌中鳞癌的发病率最高，但腺癌术后放疗后的复发率最高。术后病理提示阴道切缘阳性、有脉管浸润、有宫旁受侵的患者术后放疗后复发风险高，应严密随访。

     

    Abstract:
      Objective  To evaluate factors that affect recurrence of Ⅰb-Ⅱa cervical cancer after surgery or radiation therapy, and toprovide evidence for prevention and personalized treatment of cervical cancer recurrence.
      Methods  We retrospectively analyzed clinical and pathological data of 193 patients with stage Ⅰb-Ⅱa cervical cancer who were diagnosed and treated in Affiliated Cancer Hospital of Xinjiang Medical University from January 2010 to April 2015. The patients were assigned into the following two groups: postoperative radiotherapy recurrence group (36 cases) and non-recurrence group (157 cases). Factors related to recurrence after postoperative radiotherapy were analyzed.
      Results  The incidence rates of squamous cell carcinoma, adenocarcinoma, and other cervical cancertypes were 90.2% (174/193), 5.7% (11/193), and 4.1% (8/193), respectively. The recurrence rates of squamous cell carcinoma, adenocarcinoma, and other cervical cancer types were 16.7% (29/174), 45.5% (5/11), and 25.0% (2/8), respectively. The difference was statistically significant (χ2=12.463, P < 0.05). The proportion of patients with age ≤40 years, adenocarcinoma, vaginal margin, vascular invasion, lymph node metastasis, and parametrial invasion was higher in the relapse group than in the non-relapse group; the differencewas statistically significant between the two groups (P < 0.05). The odds ratio (OR) values for positive vaginal margin, positive vascularinvasion, and positive parametrial invasion were above 1 (P < 0.05). Therefore, these three factors were independent risk factors for cervical cancer recurrence after radiotherapy.
      Conclusions  Among stage Ⅰb-Ⅱa cervical cancer cases, squamous cell carcinoma had thehighest recurrent incidence. However, the rate of recurrence after surgery or radiation therapy was the highest for adenocarcinoma.Postoperative pathology suggests that patients with positive vaginal margins, positive vascular infiltration, and positive parametrial invasion have a high risk of recurrence after radiotherapy and should be followed-up carefully.

     

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