中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
12期
59-62
,共4页
宫颈肿瘤%腺癌%存活率分析%诊断
宮頸腫瘤%腺癌%存活率分析%診斷
궁경종류%선암%존활솔분석%진단
Uterine cervical neoplasms%Adenocarcinoma%Survival analysis%Diagnosis
目的 探讨原发性宫颈腺癌的临床特点,以提高对该病的临床诊断及治疗水平.方法 回顾性分析25例原发性宫颈腺癌患者的临床资料.结果 25例原发性宫颈腺癌患者年龄18～75(53.23±11.37)岁,绝经后20例(80％,20/25).专科检查见宫颈外形欠规则,颈管肥厚、变硬、延长、增宽.巨检类型:糜烂型1例,菜花型2例,溃疡型17例,颈管型5例.22例行子宫广泛切除术,2例行子宫次广泛切除术,1例因广泛粘连、少量腹水而手术中止,仅行化疗.手术+放疗11例,手术+同步放化疗12例.5年生存率76％(19/25),预后最差的是2例Ⅳ期患者,分别于就诊后3个月和术后9个月死亡.肿瘤最大径及国际妇产科联合会(FIGO)分期与预后有关(P＜0.05),而年龄、巨检类型、病理类型、治疗方法与预后无关(P＞0.05).结论 宫颈腺癌好发于绝经后妇女,宫颈外形欠规则、颈管肥厚、变硬、延长、增宽是常见体征.早期及肿瘤较小患者经手术为主的综合治疗5年生存率较高.肿瘤最大径＞4 cm、FIGO分期晚者预后较差.早期发现、早期诊断、早期治疗可提高5年生存率.
目的 探討原髮性宮頸腺癌的臨床特點,以提高對該病的臨床診斷及治療水平.方法 迴顧性分析25例原髮性宮頸腺癌患者的臨床資料.結果 25例原髮性宮頸腺癌患者年齡18～75(53.23±11.37)歲,絕經後20例(80％,20/25).專科檢查見宮頸外形欠規則,頸管肥厚、變硬、延長、增寬.巨檢類型:糜爛型1例,菜花型2例,潰瘍型17例,頸管型5例.22例行子宮廣汎切除術,2例行子宮次廣汎切除術,1例因廣汎粘連、少量腹水而手術中止,僅行化療.手術+放療11例,手術+同步放化療12例.5年生存率76％(19/25),預後最差的是2例Ⅳ期患者,分彆于就診後3箇月和術後9箇月死亡.腫瘤最大徑及國際婦產科聯閤會(FIGO)分期與預後有關(P＜0.05),而年齡、巨檢類型、病理類型、治療方法與預後無關(P＞0.05).結論 宮頸腺癌好髮于絕經後婦女,宮頸外形欠規則、頸管肥厚、變硬、延長、增寬是常見體徵.早期及腫瘤較小患者經手術為主的綜閤治療5年生存率較高.腫瘤最大徑＞4 cm、FIGO分期晚者預後較差.早期髮現、早期診斷、早期治療可提高5年生存率.
목적 탐토원발성궁경선암적림상특점,이제고대해병적림상진단급치료수평.방법 회고성분석25례원발성궁경선암환자적림상자료.결과 25례원발성궁경선암환자년령18～75(53.23±11.37)세,절경후20례(80％,20/25).전과검사견궁경외형흠규칙,경관비후、변경、연장、증관.거검류형:미란형1례,채화형2례,궤양형17례,경관형5례.22례행자궁엄범절제술,2례행자궁차엄범절제술,1례인엄범점련、소량복수이수술중지,부행화료.수술+방료11례,수술+동보방화료12례.5년생존솔76％(19/25),예후최차적시2례Ⅳ기환자,분별우취진후3개월화술후9개월사망.종류최대경급국제부산과연합회(FIGO)분기여예후유관(P＜0.05),이년령、거검류형、병리류형、치료방법여예후무관(P＞0.05).결론 궁경선암호발우절경후부녀,궁경외형흠규칙、경관비후、변경、연장、증관시상견체정.조기급종류교소환자경수술위주적종합치료5년생존솔교고.종류최대경＞4 cm、FIGO분기만자예후교차.조기발현、조기진단、조기치료가제고5년생존솔.
Objective To explore the clinical features of primary cervical adenocarcinoma in order to improve the level of diagnosis and treatment.Methods The clinical data of 25 patients with primary cervical adenocarcinoma were retrospectively analyzed.Results The age was 18-75 (53.23 ± 11.37) years old and 20 (80％,20/25) patients was postmenopause.The gynecologic examination showed that cervical shape was irregular,cervical canals pachynsis,hardening,extension and widen.The gross type included 1 case of erosio lump type,2 cases of fungating type,17 cases of nodus and induration ulcer type,5 cases of cervical canals type.Twenty-two patients received extensive hysterectomy and 2 patients received sub-extensive excision,1 patient was forbiddened and was only received chemical therapy for the abdominal extensively adhesions with little ascites.Twenty-three patients were performed surgery and extracorporeal irradiation or high to midst dose rate after loading program radiotherapy; twelve of them were performed chemoradiation,but eleven patients couldn' t tolerable the chemical side effects and only took radiotherapy.The 5-year survival rate was 76％ (19/25).The poorest prognostic patients were the stage Ⅳ women,which died after 3 months and 9 months respectively from first visit the doctor.The mass diameter and the early FIGO stage were correlated with prognosis (P ＜0.05).But age,gross type,pathological type,treated methods had no correlation with prognosis (P ＞ 0.05).Conclusions Cervical adenocarcinoma would be predilection postmenopause female.The common signs include cervical shape irregular,cervical canals pachynsis,hardening,extension and widen.The 5-year survival rate of the patients who received operation combined modality therapy in early stage and with small mass size is higher.The prognosis would be poor relatively in late FIGO stage and mass diameter over 4 cm.So,early discovery,early diagnosis and early treatment would be the key ways to improve 5-year survival rate.
