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目的 :探讨影响ⅠB Ⅱ期宫颈癌患者预后的高危因素。方法 :1994年 11月～ 1997年 12月本院妇瘤科收治手术治疗的ⅠB ⅡB期 (FIGO分期 )宫颈癌患者 2 30例。我们对其中 183例有完整病史资料和随访资料的患者的预后因素进行了回顾性分析。结果 :患者 2年、5年生存率分别为 77 0 2 %和 6 9 5 3%。单因素生存分析结果显示 :年龄≥ 4 0岁 ,ⅡB期患者 ,宫颈肿瘤≥ 4cm ,非鳞癌组织类型 ,盆腔淋巴结阳性 ,宫旁癌浸润 ,残端癌残留 ,深肌层浸润和脉管癌栓的患者预后较差 ,差异有统计学意义 (P <0 0 5 )。多因素生存分析结果显示≥ 2个盆腔淋巴结转移、阴道残端癌残留和脉管癌栓是影响预后最重要的危险因素 (P <0 0 5 ) ,根据这三个因素将宫颈癌患者分为低危组和高危组 ,其中高危组的 5年生存率 (39 2 2 % )明显低于低危组 (84 6 0 % ) (P <0 0 1) ,5年复发率 (6 1 6 1% )明显高于低危组 (15 4 8% ) (P <0 0 1)。结论 :高危组ⅠB-Ⅱ期宫颈癌患者预后较差 ,对有高危因素的患者应予以高度重视 ,以期减少局部复发和远处转移 ,改善患者预后。
Objective: To investigate the risk factors of prognosis in patients with stage ⅠB Ⅱ cervical cancer. Methods: From November 1994 to December 1997, 230 patients with cervical cancer ⅠB ⅡB (FIGO stage) underwent surgical treatment in our department of oncology and oncology. We retrospectively analyzed the prognostic factors of 183 patients with complete history and follow-up data. Results: The 2-year and 5-year survival rates were 77 0 2% and 69 5 3% respectively. Univariate survival analysis showed that: age ≥ 40 years, stage Ⅱ B patients, cervical cancer ≥ 4cm, non-squamous cell carcinoma type, positive pelvic lymph nodes, paracancer, residual stump cancer, deep myometrial invasion and vascular cancer Patient’s prognosis is poor, the difference was statistically significant (P <0 05). Multivariate survival analysis showed that ≥2 pelvic lymph node metastases, residual residual vaginal cancer and vascular thrombosis were the most important risk factors affecting prognosis (P <0.05). According to these three factors, cervical cancer patients were divided into In the low-risk group and the high-risk group, the 5-year survival rate (39 2 2%) in the high risk group was significantly lower than that in the low risk group (84 6 0%) (P 0 01) %) Was significantly higher than that of low risk group (15 48%) (P <0.01). Conclusion: The high risk group ⅠB-Ⅱ cervical cancer patients with poor prognosis, for patients with high risk factors should be highly valued in order to reduce the local recurrence and distant metastasis, improve prognosis.