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目的探讨影响宫颈腺癌预后的高危因素。方法选择1992年1月—2002年12月在中国协和医科大学肿瘤医院初治的159例宫颈腺癌为研究对象,收集其临床病理资料,进行预后影响因素的回顾性分析。结果患者总5年生存率为47 9%。其中临床分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的5年生存率分别为86 1%、56 4%、36 0%、0。复发或转移发生率为29 6%, 复发或转移患者的5年生存率为17 3%。单因素分析显示,肿瘤直径(P=0 009)、临床分期(P<0 01)、血CA125水平(P=0 039)等与预后有关; 27例手术治疗患者中,淋巴结转移(P=0 001)、深肌层浸润(P=0 009)与预后有关。多因素分析显示,只有临床分期、淋巴结转移是独立的预后影响因素。结论临床分期、淋巴结转移是影响宫颈腺癌预后的主要因素,提高早期检出率、改进治疗措施对于提高宫颈腺癌的生存率有重要意义。
Objective To investigate the risk factors affecting the prognosis of cervical adenocarcinoma. Methods From January 1992 to December 2002, 159 cases of newly diagnosed cervical adenocarcinoma from Cancer Hospital of Peking Union Medical College Hospital were enrolled in this study. The clinical and pathological data were collected and the prognostic factors were retrospectively analyzed. Results The overall 5-year survival rate was 47.9%. The 5-year survival rates of patients with clinical stage I, II, III and IV were 86.1%, 56.4% and 36.0%, respectively. The incidence of recurrence or metastasis was 29.6%, and the 5-year survival rate of patients with recurrence or metastasis was 17.3%. Univariate analysis showed that tumor diameter (P = 0 009), clinical stage (P <0.01) and blood CA125 level (P = 0 039) were related to prognosis. Among 27 surgical patients, lymph node metastasis 001), deep myometrial invasion (P = 0 009) and prognosis. Multivariate analysis showed that only clinical stage, lymph node metastasis is an independent prognostic factor. Conclusions Clinical stage and lymph node metastasis are the main factors affecting the prognosis of cervical adenocarcinoma. To improve early detection rate and improve therapeutic measures are of great significance to improve the survival rate of cervical adenocarcinoma.