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目的探讨Ⅱb~Ⅲ期宫颈癌患者的疗效及预后相关因素。方法分析2007年3月至2008年10月辽宁省肿瘤医院收治的264例宫颈癌患者的临床资料。结果 264例患者的中位随访时间75个月,2、5年总生存率(overall survival,OS)分别为77.7%、65.5%。2、5年肿瘤特异性生存率(disease-specific survival,DSS)分别为78.1%、66.5%。2、5年无病生存率(disease-free survival,DFS)分别为72.7%、64.2%。单因素分析显示,影响OS、DSS、DFS的因素有临床分期(Ⅱb期与Ⅲ期,P<0.01),肿瘤大小(<4 cm、4~6 cm、>6 cm,P<0.01)、病理类型(鳞癌与腺癌,P<0.01)、阴道受侵范围(无、上1/3、中1/3、下1/3,P<0.01)、淋巴结情况(盆腔腹主阴性、仅盆腔阳性、盆腔腹主阳性、未做CT,P<0.01)、最低血红蛋白(>110 g/L、95~110 g/L、75~<95 g/L、52~<75 g/L,P<0.01)。入院血红蛋白是DFS的影响因素。多因素分析显示,临床分期、病理类型、淋巴结情况、治疗方式、最低血红蛋白为宫颈癌OS、DSS和DFS的独立预后因素。结论Ⅲ期、腺癌、淋巴结阳性、单纯放疗以及最低血红蛋白<75 g/L的宫颈癌患者预后不良。
Objective To investigate the efficacy and prognosis of patients with stage Ⅱb ~ Ⅲ cervical cancer. Methods The clinical data of 264 patients with cervical cancer admitted to Liaoning Provincial Tumor Hospital from March 2007 to October 2008 were analyzed. Results The median follow-up time of 264 patients was 75 months. The overall survival rates at 2 and 5 years were 77.7% and 65.5%, respectively. The 2-year and 5-year disease-specific survival (DSS) were 78.1% and 66.5% respectively. The 2 and 5 year disease-free survival (DFS) were 72.7% and 64.2% respectively. Univariate analysis showed that the factors influencing OS, DSS and DFS were clinical stage (stage Ⅱb and Ⅲ, P <0.01), tumor size (4 cm, 4 to 6 cm, and 6 cm, P <0.01) (Squamous cell carcinoma and adenocarcinoma, P <0.01), vaginal invasion range (none, upper 1/3, middle 1/3, lower 1/3, P <0.01) (P> 0.05). The lowest hemoglobin (> 110 g / L, 95-110 g / L, 75 ~ <95 g / L and 52 ~ <75 g / L, P < 0.01). Admission hemoglobin is the influencing factor of DFS. Multivariate analysis showed that clinical stage, pathological type, lymph node status, treatment modalities and minimum hemoglobin were independent prognostic factors of cervical cancer OS, DSS and DFS. Conclusion The prognosis of patients with stage Ⅲ, adenocarcinoma, lymph node positive, radiotherapy alone and cervical cancer with minimum hemoglobin <75 g / L is poor.