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J Zhejiang Univ (Med Sci)  2018, Vol. 47 Issue (4): 357-361    DOI: 10.3785/j.issn.1008-9292.2018.08.05
    
Clinical features and prognosis of cervical adenocarcinoma and adenosquamous carcinoma: an analysis of 237 cases
CHEN Qian(),LIU Lu,ZHANG Jingjing,HAN Sai,CUI Baoxia,ZHANG Youzhong*(),KONG Beihua
Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, China
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Abstract  

Objective: To analyze the clinical features and prognosis of cervical adenocarcinoma (AC) and adenosquamous carcinoma of cervix (ASC). Methods: The clinical data of 237 patients, including 201 cases of AC and 36 cases of ASC (FIGO stage ⅠB1-ⅡA), who underwent surgery in Qilu Hospital between September 2007 and September 2016 were reviewed. Clinical features of two groups were compared, and Kaplan-Meier survival analysis was performed to evaluate the prognosis. Results: A larger proportion of ASC patients had lymphovascular space invasion compared with AC patients (P < 0.01), but no significant differences were observed in the age, FIGO stage, size of tumor, depth of stromal invasion, parametrial invasion, lymphatic metastasis and risk grade between two groups (all P>0.05). The 5-year overall survival rates of AC and ASC groups were 79.4% and 78.3%, and the 5-year recurrence-free survival rates were 77.4% and 73.0%. Among patients received concurrent chemoradiotherapy, the 5-year overall survival rates were 71.0% and 61.4%, and the 5-year recurrence-free survival rates were 68.8% abd 61.1%, respectively. No significant differences were observed in 5-year overall survival rates and recurrence-free survival rates between AC and ASC patients (all P>0.05). Conclusion: Lymphovascular space invasion was more likely to occur in patients with ASC, but there was no significant difference in the prognosis between AC and ASC patients.



Key wordsUterine cervical neoplasms/pathology      Carcinoma, squamous cell/pathology      Adenocarcinoma/pathology      Neoplasm invasiveness      Lymphatic metastasis      Survival rate      Prognosis     
Received: 03 July 2018      Published: 04 December 2018
CLC:  R737.33  
Corresponding Authors: ZHANG Youzhong     E-mail: 18769781275@163.com;zhangyouzhong@sdu.edu.cn
Cite this article:

CHEN Qian,LIU Lu,ZHANG Jingjing,HAN Sai,CUI Baoxia,ZHANG Youzhong,KONG Beihua. Clinical features and prognosis of cervical adenocarcinoma and adenosquamous carcinoma: an analysis of 237 cases. J Zhejiang Univ (Med Sci), 2018, 47(4): 357-361.

URL:

http://www.zjujournals.com/med/10.3785/j.issn.1008-9292.2018.08.05     OR     http://www.zjujournals.com/med/Y2018/V47/I4/357


237例宫颈腺癌及腺鳞癌患者临床特征及预后分析

目的: 探讨宫颈腺癌和宫颈腺鳞癌患者的临床特征和预后差异。方法: 回顾性分析2007年9月至2016年9月因ⅠB1~ⅡA期宫颈腺癌(201例)或宫颈腺鳞癌(36例)在山东大学齐鲁医院手术治疗患者的临床资料。比较两组的临床特征,并采用Kaplan-Meier生存曲线对两种组织学类型宫颈癌的预后进行评价。结果: 宫颈腺鳞癌组淋巴血管浸润比例较宫颈腺癌组高(P < 0.01),而在年龄、FIGO分期、肿瘤直径、间质浸润深度、宫旁浸润、淋巴结转移和危险分级方面两组差异均无统计学意义(均P>0.05)。宫颈腺癌组和宫颈腺鳞癌组患者5年总存活率分别为79.4%和78.3%,5年无复发存活率分别为77.4%和73.0%,组间差异均无统计学意义(均P>0.05)。术后接受同步放射治疗和化疗的患者中,5年总存活率分别为71.0%和61.4%,5年无复发存活率分别为68.8%和61.1%,组间差异均无统计学意义(均P>0.05)。结论: 宫颈腺鳞癌较宫颈腺癌更易发生淋巴血管浸润,但两者的预后相似。


关键词: 宫颈肿瘤/病理学,  癌, 鳞状细胞/病理学,  腺癌/病理学,  肿瘤浸润,  淋巴转移,  存活率,  预后 
[n(%)]
组别 n FIGO分期 肿瘤直径超过4 cm 淋巴血管浸润 间质浸润深度(>1/2) 宫旁浸润 淋巴结转移 危险分级(中高危*)
ⅠB ⅡA
“—”无相关数据.*高危是指出现以下一个或一个以上因素:盆腔淋巴结阳性、宫旁浸润、手术切缘阳性[17];中危是指出现以下两个或两个以上因素:间质浸润深度大于1/2、淋巴血管浸润阳性、肿瘤直径大于4 cm[18].
宫颈腺癌组 201 166(82.6) 35(17.4) 35(17.4) 25(12.4) 108(53.7) 10(5.0) 50(24.9) 154(76.6)
宫颈腺鳞癌组 36 26(72.2) 10(27.8) 9(25.0) 11(30.6) 25(69.4) 3(8.3) 6(16.7) 28(77.8)
χ2 2.13 1.16 7.78 3.06 0.66 1.14 0.02
P >0.05 >0.05 <0.01 >0.05 >0.05 >0.05 >0.05
Tab 1 Clinical features of the adenocarcinoma and adenosquamous carcinoma groups
Fig 1 Kaplan-Meier survival curves for cervical adenocarcinoma and adenosquamous carcinoma patients
Fig 2 Kaplan-Meier survival curves for cervical adenocarcinoma and adenosquamous carcinoma patients received adjuvant CCRT
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