宫颈癌治疗后未控或复发135 例分析

目的：探讨宫颈癌治疗后未控、复发的相关因素。方法：回顾性分析2000年8月至2003年8月山东省肿瘤医院妇瘤科收治的135例治疗后复发或未控的宫颈癌患者的临床病理资料，分析初治时的发病年龄、临床分期、病理类型、肿瘤分化程度、肿瘤生长形态、肿瘤大小以及初治方法和完成情况。结果：发病年龄最小27岁，最大72岁，平均年龄49．9岁，发病年龄≤35y的患者18例（13．1％）；Ⅰ期3例（2．2％）、Ⅱ期52例（38．5％）、Ⅲ期80例60．0％；鳞癌104（75．6％）、腺癌26例（19．3％）、特殊类型7例（5．1％）；高分化14例（10．4％）、中分化88例（53．6％）、低分化33例（24．4％）；糜烂型Ⅱ例（0．7％）、菜花型33例（24．4％）、结节型69例（51．1％）、空洞型27例（20％）、颈管型5例（3．7％）；肿瘤直径≥4cm患者93例（68．9％）；48例患者首选手术治疗，其中外院手术22例、术中有肿瘤残留的10例、术后病理提示具有预后危险因素而未在4周内补充治疗的17例；87例患者放疗为主，其中37例门诊放疗、21例放疗时间超过3个月。结论：宫颈癌治疗后来控、复发的相关因素有临床期别晚、非鳞癌等多种，应争取早期发现、规范治疗采提高疗效。

Analysis of clinical and pathological factors in 135 cases of persistent or recurrent cervical cancer

Objective: To approach the factors associated with persistent or recurrent cervical cancer . Methods: Totally, 135 cases of persistent or recurrent cervical cancer were retrospectively studied. Clinical and patholog ical data including patient?? s age, stage, histological subtype, grade, tumor size and treatment were reviewed. Results: Ages of onset of the patients ranged from 27 to 72 years, mean age was 49. 9 years, there were 18( 13. 1%) patients with age of onset ?? 35 years. According to International Federation of Gynecology and Obstetrics( FIGO) , patients with stages?? , ?? , ?? accounted for 2. 2%, 38. 5%, 60. 0% respectively. Squamous carcinoma, adenocarcinoma, and others accounted for 104( 75. 6%) , 26( 19. 3%) , 7( 5. 1%) respectively. Well- differentiated, moderately differentiated, poorly differentiated patients accounted for 14( 10. 4%) , 88( 53. 6%) , 33 ( 24. 4%) respectively. The tumor growth type were as follows: anabrosis 1l( 0. 7%) , cauliflower 33( 24. 4%) , nodus 69( 51. 1%) , cavitas 27( 20%) , canalis cervicis 5 ( 3. 7%) . There were 93( 68. 9%) patients with tumor diameter ??4cm. 48 patients selected surgery and 22 patients had been operated in other hospitals, 10 patients had residual disease, 17 patients had risk prognostic factors but hadn?? t been given adjuvant therapy in time. Including 37 outpatients, 87 patients selected radiotherapy, 21 patients?? course of therapy had exceeded 3 months. Conclusion: Many factors are associated with persistent or recurrent cervical cancer such as late stage, non squamous carcinoma, tumor diameter ??4cm and so on. To enhance the curative effect, we should strive for early discovery and exact therapy.