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目的:探讨宫颈癌远处转移的发生率、危险期、好发部位、治疗疗效及影响远处转移时间的高危因素。方法:回顾性分析2000-04-01-2011-10-31我院收治的892例宫颈癌患者中发生远处转移的37例患者的临床资料。结果:宫颈癌远处转移发生率为4.1%(37/892);远处转移的发生时间大都在治疗开始2年内,占73%(27/37);远处转移部位以远处淋巴结居多(除外盆腔内淋巴结),占51.4%(19/37),肺占37.8%(14/37)、骨占24.3%(9/37)、肝及其他部位占24.3%(9/37)。宫颈癌患者盆腔复发率为11.9%(106/892),其远处转移患者中伴盆腔复发为78.4%(29/37),单纯盆腔复发患者的同步放化疗2年生存率较远处转移患者高,χ2=22.471,P=0.000。宫颈癌远处转移时间的危险因素:高分化患者发生远处转移的时间明显长于低、中分化,P值分别为0.000和0.001;但是中分化与低分化患者发生远处转移的时间差异无统计学意义,P=0.240。<60岁的患者发生远处转移的时间均明显早于>60岁的患者,P值分别为0.002和0.001;但是<60岁的患者中,<40岁与40~60岁的患者发生远处转移的时间差异无统计学意义,P=0.956。ⅠB与ⅡA,ⅡA与ⅡB,Ⅲ与Ⅳ期患者发生远处转移的时间差异均无统计学意义,P值分别为0.706、0.051和0.695;但是ⅡB期发生远处转移时间明显晚于Ⅲ、Ⅳ期,P值分别为0.021和0.013。结论:子宫颈癌远处转移大都出现在治疗开始2年内,以淋巴结、肺等为主要转移部位且治疗疗效较差,分化差、分期晚的年轻患者更易出现远处转移,提示出临床上应加强易发宫颈癌远处转移的高危人群的监测和随访。
Objective: To investigate the incidence of distant metastasis of cervical cancer, dangerous period, the site of treatment, therapeutic efficacy and risk factors affecting distant metastasis time. Methods: The clinical data of 37 patients with distant metastasis in 892 cervical cancer patients who were admitted to our hospital from 2000-04-01-2011-10-31 were retrospectively analyzed. Results: The incidence of distant metastasis of cervical cancer was 4.1% (37/892). The distant metastasis occurred mostly in 2 years (73%, 27/37) Except for pelvic lymph nodes, accounting for 51.4% (19/37), lungs accounting for 37.8% (14/37), bones accounting for 24.3% (9/37) and liver and other parts accounting for 24.3% (9/37). The pelvic recurrence rate was 11.9% (106/892) in cervical cancer patients, and pelvic recurrence was 78.4% (29/37) in patients with distant metastasis. The 2-year survival rate of patients with pelvic recurrence was significantly higher than that of patients with distant metastasis High, χ2 = 22.471, P = 0.000. Risk factors for distant metastasis of cervical cancer: The distant metastasis of well-differentiated patients was significantly longer than that of low and moderately differentiated patients, with P values of 0.000 and 0.001, respectively. However, there was no statistical difference in the distant metastasis between patients with moderately differentiated and poorly differentiated Significance of learning, P = 0.240. Patients <60 years of age had a significantly longer distant metastasis than those aged> 60 years with P values of 0.002 and 0.001, respectively; however, patients <40 years of age and 40-60 years of age <60 years were distant There was no significant difference in the time of metastasis, P = 0.956. There was no significant difference in the time of distant metastasis between ⅠB and ⅡA, ⅡA and ⅡB, Ⅲ and Ⅳ patients, P values were 0.706,0.051 and 0.695 respectively; however, the distant metastasis of ⅡB was significantly later than Ⅲ and Ⅳ The P values were 0.021 and 0.013, respectively. Conclusion: Most distant metastases of cervical cancer appear in the first 2 years of treatment, with lymph nodes, lungs as the main site of metastasis and the treatment of poor, poorly differentiated, late stage young patients more prone to distant metastasis, suggesting that clinical To strengthen the monitoring and follow-up of high-risk groups susceptible to distant metastasis of cervical cancer.