宫颈鳞状细胞癌Ⅲ级与Ⅰ、Ⅱ级病例的病理预后分析_临床医学论文.docVIP

宫颈鳞状细胞癌Ⅲ级与Ⅰ、Ⅱ级病例的病理预后分析_临床医学论文 宫颈鳞状细胞癌Ⅲ级与Ⅰ、Ⅱ级病例的病理预后分析_临床医学论文 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] Objective To explore the differences between the patients of grade Ⅰ,Ⅱ and Ⅲ cervical squamous cell carcinoma, on age ,clinical stage, high risk factors, adjunctive therapy after operation and death rate. And to investigate the influence of different adjunctive therapy to the prognosis of grade Ⅲ cervical squamous cell carcinoma.Methods Total 145 patients, with full follow-up, were chosen in the retrospective study, who were cured in the 4th hospital of Hebei Medical University (included the department of Gynecology and Obstetrics, and the department of Gynecologic Oncology) from 2003 January to 2006 December.Results The patients of grade Ⅰ,Ⅱ and Ⅲ cervical squamous cell carcinoma, whose age was less than 40 years old, accounted for 17.28% and 20.31% respectively (P=0.84). The defference of 3-year death rate was not significantly different between grade Ⅰ,Ⅱ and Ⅲ cervical squamous cell carcinoma. But there are more patients with high risk factors and more were chosen for adjunctive therapy after operation in grade Ⅲ cervical squamous cell carcinoma. And the 3-year survival rates were not different after single chemotherapy or radiochemotherapy.Conclusion It’s common that grade Ⅲ cervical squamous cell carcinoma patients have more risk factors. But the difference of 3-year death rate is not significantly different between grade Ⅰ,Ⅱ and Ⅲ cervical squamous cell carcinoma because of the adjunctive therapy after operation. The effect of chemotherap