宫颈鳞状细胞癌ⅲ级与ⅰ、ⅱ级病例的病理预后分析

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1、宫颈鳞状细胞癌Ⅲ级与Ⅰ、Ⅱ级病例的病理预后分析作者：李方，康山，马明娜，程建新，李利【摘要】目的探讨宫颈鳞癌Ⅲ级与Ⅰ、Ⅱ级患者的年龄、临床分期、高危因素、术后辅助治疗选择及死亡率等情况的差别，以及不同术后辅助治疗方式对宫颈鳞癌Ⅲ级预后的影响。方法收集2003年1月-2006年12月在河北医科大学第四医院(包括妇产科及妇瘤科)进行治疗并可以完整随访到的宫颈鳞状细胞癌病例145例，进行回顾性研究。结果从年龄分布上分析，≤40岁发病的患者在宫颈鳞状细胞癌Ⅲ级中占20.31%，在Ⅰ、Ⅱ级中占17.28%(P=0.84)。宫颈鳞癌Ⅲ级患者的3年死亡率与Ⅰ、Ⅱ级的宫颈鳞癌相差不大。术后具

2、有高危因素的患者要高于Ⅰ、Ⅱ级组织分化较好的病例，选择术后辅助治疗的比例也多于组织分化较好的宫颈鳞癌病例。采用化疗与放化疗的3年生存率无明显差异。结论宫颈鳞癌Ⅲ级患者合并高危因素较常见，但由于术后辅助治疗比较积极，其3年死亡率与Ⅰ、Ⅱ级的宫颈鳞癌并没有很大差别。化疗可达到与放化疗一样的效果，可选择应用于年轻患者。【关键词】宫颈鳞癌Ⅲ级;年龄;高危因素;死亡率　[Abstract]ObjectiveToexplorethedifferencesbetween9thepatientsofgradeⅠ,ⅡandⅢcervicalsquamouscellcarcinoma,onage

3、,clinicalstage,highriskfactors,adjunctivetherapyafteroperationanddeathrate.AndtoinvestigatetheinfluenceofdifferentadjunctivetherapytotheprognosisofgradeⅢcervicalsquamouscellcarcinoma.MethodsTotal145patients,withfullfollow-up,werechosenintheretrospectivestudy,whowerecuredinthe4thhospitalofHe

4、beiMedicalUniversity(includedthedepartmentofGynecologyandObstetrics,andthedepartmentofGynecologicOncology)from2003Januaryto2006December.ResultsThepatientsofgradeⅠ,ⅡandⅢcervicalsquamouscellcarcinoma,whoseagewaslessthan40yearsold,accountedfor17.28%and20.31%respectively(P=0.84).Thedefferenceof

5、3-yeardeathratewasnotsignificantlydifferentbetweengradeⅠ,ⅡandⅢcervicalsquamouscellcarcinoma.ButtherearemorepatientswithhighriskfactorsandmorewerechosenforadjunctivetherapyafteroperationingradeⅢcervicalsquamouscellcarcinoma.Andthe3-yearsurvivalrateswerenotdifferentaftersinglechemotherapyorra

6、diochemotherapy.ConclusionIt’scommonthatgradeⅢcervicalsquamouscellcarcinomapatientshavemoreriskfactors.Butthedifferenceof3-yeardeathrateisnotsignificantlydifferentbetweengradeⅠ,ⅡandⅢcervical9squamouscellcarcinomabecauseoftheadjunctivetherapyafteroperation.Theeffectofchemotherapyissimilartot

7、heradiochemotherapyingradeⅢcervicalsquamouscellcarcinoma.Thenthechemotherapymaybeusedintheyoungpatients.　　[Keywords]gradeⅢcervicalsquamouscellcarcinoma;age;highriskfactor;deathrate　　宫颈鳞状细胞癌是妇科常见恶性肿瘤之一，细胞分化上分为Ⅰ、Ⅱ级与Ⅲ级，其预后明显不同。近年来，Ⅲ级宫颈鳞状细胞癌在年轻患者中的发生率有升高趋势，这