文章摘要
陈艳,胡卫平,吴大保,李红,张爱君,孙敏文 [中国科学技术大学附属第一医院.早期子宫颈神经内分泌癌27例临床分析[J].中国临床保健杂志,2019,22(2):270-274.
早期子宫颈神经内分泌癌27例临床分析
Clinical analysis of 27 cases of early neuroendocrine carcinoma of the uterine cervix
投稿时间:2018-12-20  
DOI:10.3969/J.issn.1672-6790.2019.02.033
中文关键词: 宫颈肿瘤  危险因素  存活率  预后
英文关键词: Uterine cervical neoplasms  Risk factors  Survival rate  Prognosis 〖FL
基金项目:安徽省公益性研究联动计划(15011d04023)
作者单位E-mail
陈艳 [中国科学技术大学附属第一医院安徽省立医院妇产科,合肥 230001] syhwp@163.com 
胡卫平 [中国科学技术大学附属第一医院安徽省立医院妇产科,合肥 230001] syhwp@163.com 
吴大保 [中国科学技术大学附属第一医院安徽省立医院妇产科,合肥 230001] syhwp@163.com 
李红 [中国科学技术大学附属第一医院安徽省立医院妇产科,合肥 230001] syhwp@163.com 
张爱君 [中国科学技术大学附属第一医院安徽省立医院妇产科,合肥 230001] syhwp@163.com 
孙敏文 [中国科学技术大学附属第一医院 [中国科学技术大学附属第一医院安徽省立医院妇产科,合肥 230001] syhwp@163.com 
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中文摘要:
      目的 分析早期子宫颈神经内分泌癌(NECUC)复发及生存情况,探讨其治疗及预后。 方法 回顾性分析27例早期NECUC患者的临床病理资料。Kaplan-Meier法和log-rank法进行生存分析。 结果(1)2年OS、PFS分别为88.8%、66.7%;5年总生存时间(OS)、无进展生存时间(PFS)分别为74.1%、59.2%,中位PFS为18个月。随访期内40%患者复发,其中81.8%为远处转移。(2)术后单纯化疗(CT)者(n=7)与放疗(RT)/同步放化疗(CCRT)+CT者(n=20)的2年、5年OS及PFS差异无统计学意义(P>0.05);术后依托泊苷+铂类(EP)≥5个周期(n=16)和Non-EP≥5个周期(n=11)化疗的2年OS、5年OS及PFS差异有统计学意义(P<0.05)。(3)单因素生存分析和多因素分析显示:淋巴转移,术后Non-EP≥5化疗均是复发的危险因素。 结论(1)早期NECUC预后较差,2年内约40%患者复发,且远处转移较显著。(2)术后EP≥5个周期化疗能提高患者的生存率。额外的RT或CCRT未能明显提高患者的生存率。(3)淋巴转移和术后Non-EP≥5化疗是术后复发的危险因素。
英文摘要:
      Objective To analyze the recurrence and survival of early stage neuroendocrine carcinoma of the uterine cervix (NECUC),and to investigate the treatment method and the prognostic factors. Methods The clinical and pathological data of 27 patients with early NECUC were retrospectively analyzed.Kaplan-Meier and log-rank methods were used for survival analyses. Results (1) Over survival time(OS) and PFS were 88.8% and 66.7% respectively in 2 years,and 74.1% and 59.2% respectively in 5 years.The median PFS was 18 months.During the follow-up period,40% patients had recurrence,and 81.8% of which had distant metastases.(2) There was no significant difference in OS and PFS at 2 and 5 years (P>0.05) between 7 patients undergoing chemotherapy (CT) after surgery and 20 patients receiving radiotherapy (RT)/combined radiochemotherapy (CCRT) + chemotherapy.And there was significant difference in OS and PFS at 2 and 5 years (P<0.05) between 16 patients with chemotherapy of EP ≥ 5 cycles and 11 patients with Non-EP ≥ 5 cycles after surgery.(3) Single factor survival analysis and the multivariable Cox regression model showed that lymphatic metastasis,postoperative adjuvant chemotherapy of Non-EP ≥ 5 cycles were risk factors for recurrence. Conclusion (1) Early NECUC has a poor prognosis,with about 40% of patients relapsed within 2 years and significant distant metastasis.(2) Treatment with EP ≥ 5 cycles of EP regimen can improve patient survival.Additional radiotherapy or concurrent chemoradiotherapy cannot significantly improve patient survival.(3) Lymphatic metastasis and treatment of Non-EP ≥ 5 cycles after surgery are risk factors for postoperative recurrence.
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