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目的:探讨体重指数(BMI)对接受广泛性子宫切除术的子宫颈癌Ⅰb期患者预后的影响。方法:回顾性分析1987年4月～1997年4月行广泛性子宫切除的子宫颈癌Ⅰb期患者87例,根据BMI不同将其分为3组,即BMI-S组(BMI<20)23例;BMI-M组(20≤BMI<27)48例;BMI-L组(BMI≥27)16例。分析3组5年生存率及预后因素的关系。结果:BMI-S组、BMI-M组及BMI-L组5年生存率分别为64.3%、87.9%及91.3%;BMI-S组与BMI-M组、BMI-L组之间比较,有显著性差异(P<0.05)。各组间年龄、组织学类别、细胞分化程度、淋巴结转移率、平均肿瘤直径比较,无显著性差异(P>0.05)。BMI-S组与BMI-M组、BMI-L组有深肌层浸润者分别为82.6%、50.2%、37.9%,BMI-S组与BMI-M组、BMI-L组之间比较,有显著性差异(P<0.05)。采用COX模型多变量分析结果表明,平均肿瘤直径(P<0.01)、有无淋巴结转移(P<0.05)及BMI<20(P<0.01)是影响预后的独立因素。结论:体重指数与子宫颈癌Ⅰb期预后有关,低体重患者预后较差。
Objective: To investigate the effect of body mass index (BMI) on the prognosis of patients with stage Ⅰb cervical cancer undergoing extensive hysterectomy. Methods: A total of 87 patients with stage Ⅰb cervical cancer who underwent extensive hysterectomy from April 1987 to April 1997 were retrospectively analyzed. The BMI-S group (BMI <20) 23 Cases of BMI-M group (20≤BMI <27) 48 cases; BMI-L group (BMI≥27) 16 cases. The relationship between 5-year survival rate and prognostic factors in 3 groups was analyzed. Results: The 5-year survival rates of BMI-S, BMI-M and BMI-L groups were 64.3%, 87.9% and 91.3% respectively. There was significant difference between BMI-S group and BMI-M group and BMI-L group Significant difference (P <0.05). There was no significant difference in age, histological classification, degree of cell differentiation, lymph node metastasis and mean tumor diameter between groups (P> 0.05). BMI-S group and BMI-M group, BMI-L group were deep myometrial invasion were 82.6%, 50.2%, 37.9%, BMI-S group and BMI-M group, BMI- Significant difference (P <0.05). Multivariate analysis using COX model showed that the average tumor diameter (P <0.01), lymph node metastasis (P <0.05) and BMI <20 (P <0.01) were independent prognostic factors. Conclusion: The body mass index is related to the prognosis of stage Ⅰb cervical cancer. The patients with low body weight have a poor prognosis.