肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2014年
5期
306-309,314
,共5页
谢文佳%周礼雅%高颜凤%翟田田%吴丽丽%谢良喜
謝文佳%週禮雅%高顏鳳%翟田田%吳麗麗%謝良喜
사문가%주례아%고안봉%적전전%오려려%사량희
子宫颈肿瘤%根治性放化疗%淋巴结转移%计算机断层扫描%预后因素
子宮頸腫瘤%根治性放化療%淋巴結轉移%計算機斷層掃描%預後因素
자궁경종류%근치성방화료%림파결전이%계산궤단층소묘%예후인소
Uterine cervical neoplasms%Radical chemoradiation therapy%Lymph node metastasis%Computed tomography%Prognostic factor
目的 以治疗前CT评估盆腹腔淋巴结转移状况,探讨其对根治性放化疗子宫颈癌患者的预测价值.方法 回顾性分析2005年4月至2009年1 1月期间在汕头大学医学院附属肿瘤医院放疗科行根治性放化疗的209例ⅠB～ⅣA期子宫颈癌患者治疗前的CT资料,分别以部位、数目、大小三种方法评估盆腹腔淋巴结转移状况.利用Kaplan-Meier法分析淋巴结转移状况及其他临床病理因素对患者总生存的影响,并采用Cox回归模型进行多因素分析.结果 ⅠB、Ⅱ、Ⅲ、ⅣA期患者淋巴结转移率分别为16.7％(1/6)、48.2％(68/141)、57.4％(31/54)、87.5％(7/8).单因素分析显示国际妇产科协会(FIGO)分期晚、治疗前贫血、腹主动脉旁淋巴结转移、淋巴结转移数目≥3个、转移淋巴结最大径≥2.0cm为预后不良因素(P＜0.05);Cox回归模型显示FIGO分期、淋巴结转移数目、病理类型及治疗方式为独立预后因素.结论 在同步放化疗模式下,以治疗前CT评估淋巴结转移状况仍然可以很好的预测预后.
目的 以治療前CT評估盆腹腔淋巴結轉移狀況,探討其對根治性放化療子宮頸癌患者的預測價值.方法 迴顧性分析2005年4月至2009年1 1月期間在汕頭大學醫學院附屬腫瘤醫院放療科行根治性放化療的209例ⅠB～ⅣA期子宮頸癌患者治療前的CT資料,分彆以部位、數目、大小三種方法評估盆腹腔淋巴結轉移狀況.利用Kaplan-Meier法分析淋巴結轉移狀況及其他臨床病理因素對患者總生存的影響,併採用Cox迴歸模型進行多因素分析.結果 ⅠB、Ⅱ、Ⅲ、ⅣA期患者淋巴結轉移率分彆為16.7％(1/6)、48.2％(68/141)、57.4％(31/54)、87.5％(7/8).單因素分析顯示國際婦產科協會(FIGO)分期晚、治療前貧血、腹主動脈徬淋巴結轉移、淋巴結轉移數目≥3箇、轉移淋巴結最大徑≥2.0cm為預後不良因素(P＜0.05);Cox迴歸模型顯示FIGO分期、淋巴結轉移數目、病理類型及治療方式為獨立預後因素.結論 在同步放化療模式下,以治療前CT評估淋巴結轉移狀況仍然可以很好的預測預後.
목적 이치료전CT평고분복강림파결전이상황,탐토기대근치성방화료자궁경암환자적예측개치.방법 회고성분석2005년4월지2009년1 1월기간재산두대학의학원부속종류의원방료과행근치성방화료적209례ⅠB～ⅣA기자궁경암환자치료전적CT자료,분별이부위、수목、대소삼충방법평고분복강림파결전이상황.이용Kaplan-Meier법분석림파결전이상황급기타림상병리인소대환자총생존적영향,병채용Cox회귀모형진행다인소분석.결과 ⅠB、Ⅱ、Ⅲ、ⅣA기환자림파결전이솔분별위16.7％(1/6)、48.2％(68/141)、57.4％(31/54)、87.5％(7/8).단인소분석현시국제부산과협회(FIGO)분기만、치료전빈혈、복주동맥방림파결전이、림파결전이수목≥3개、전이림파결최대경≥2.0cm위예후불량인소(P＜0.05);Cox회귀모형현시FIGO분기、림파결전이수목、병리류형급치료방식위독립예후인소.결론 재동보방화료모식하,이치료전CT평고림파결전이상황잉연가이흔호적예측예후.
Objective To investigate the prognostic value of lymph node status evaluated by computed tomography (CT) in cervical carcinoma treated with radical chemoradiation therapy.Methods 209 patients with FIGO stage Ⅰ B-ⅣA uterine cervical carcinoma treated with radical chemo radiation therapy were enrolled.Lymph node status was evaluated based on site,number and size respectively by CT.Kaplan-Meier method was used to analyze the impact of lymph node status as well as other pathoclinical factors on overall survival (OS).Cox regression model was used to explore the relationship between independent prognostic factors and OS.Results Lymph node metastasis rates for stage Ⅰ B,Ⅱ,Ⅲ and ⅣA patients were 16.7 ％ (1/6),48.2 ％ (68/141),57.4 ％ (31/54) and 87.5 ％ (7/8),respectively.Variate analysis showed that FIGO stage,anemia before treatment,para-aortic lymph node metastasis,and the number (≥3) and size (maximum diameter ≥ 2.0 cm) of CT positive lymph node were significant unfavorable prognostic factors for OS (P ＜ 0.05).FIGO stage,the number of lymph nodes metastasis,pathologic diagnosis and treatment regimen were identified to be independent prognostic factors in multivariate analysis.Conclusion Under current therapeutic strategy of concomitant chemoradiotherapy,lymph node metastatic status evaluated by pretreatment CT is still a significant and independent prognostic factor for cervical cancer.
