摘要
目的 探讨新辅助化疗联合宫颈癌根治术治疗IB2~ⅡB期宫颈癌的效果.方法 根据治疗方案将2012年10月至2016年10月我院收治的80例IB2~ⅡB期宫颈癌患者分为观察组43例与对照组37例.观察组患者行新辅助化疗联合宫颈癌根治术治疗,对照组患者直接接受宫颈癌根治术治疗.比较两组患者的化疗效果、手术时间及术中出血量、术后病理高危因素的差异.结果 （1）观察组化疗后疗效,鳞癌组完全缓解（CR）4例、部分缓解（PR）22例、疾病稳定（SD）6例、疾病进展（PD）0例,腺癌组CR 1例、PR 3例、SD 5例、PD 2例,鳞癌组化疗疗效显著优于腺癌组,差异有统计学意义（z=2.4968,P=0.0063）.（2）观察组手术时间（215±57） min、术中出血量（682±145） ml,显著低于对照组[（259±62） min、（758±193） ml],差异有统计学意义（t值分别为3.8780、2.2528,P=0.0002、P=0.0263）.（3）两组患者输尿管瘘（P=0.5039）、膀胱阴道瘘（P=0.3639）、切口愈合不良（P=0.5182）、下肢深静脉血栓（P=0.4818）等并发症发生率相比差异无统计学意义.（4）观察组淋巴结阳性率（χ2=8.2005,P=0.0000）、宫旁浸润率（χ2=8.1553,P=0.0000）显著低于对照组,差异有统计学意义;两组患者深肌层浸润率（χ2=0.0991,P=0.7516）、脉管癌栓发生率（χ2=0.0130,P=0.9176）相比差异无统计学意义.结论 新辅助化疗对宫颈癌鳞癌的疗效优于腺癌.与直接行宫颈癌根治术相比,新辅助化疗联合宫颈癌根治术治疗IB2~ⅡB期宫颈癌患者的手术时间、术中出血量更低,在淋巴结阳性、宫旁浸润等术后病理高危因素方面亦可以获得更佳的效果.
Objective To investigate the efficacy of neoadjuvant chemotherapy combined with radical resection of cervical cancer in the treatment of stage IB2-ⅡB cervical cancer.Methods According to the treatment plan from October 2012 to October 2016 in the People′s Hospital of Luohu District of Shenzhen in 80 cases of stage IB2-II B cervical cancer patients were divided into observation group（n=43） and control group（n=37）,the observation group was treated with neoadjuvant chemotherapy combined with radical surgery for cervical cancer,patients in the control group directly treated for radical resection of cervical cancer.Chemotherapy effect,operation time,intraoperative blood loss,postoperative pathological risk factor differences of two groups of patients were compared.Results （1）Evaluated the curative effect of neoadjuvant chemotherapy,squamous cell carcinoma group complete remission（CR） 4 cases,partial remission（PR） 22 cases,stable disease（SD）,6 cases of disease progression（PD） in 0 cases,in adenocarcinoma group CR 1 cases,PR 3 cases,SD 5 cases,PD 2 cases of squamous cell carcinoma group adjuvant chemotherapy was significantly better than that of adenocarcinoma group,the difference was statistically significant（z=2.4968,P=0.0063）.（2）The operation time（（215±57） min） and intraoperative blood loss（（682±145） ml） in the observation group were significantly lower than those in the control group（（（259±62） min,（758±193） ml））,the difference was statistically significant（t=3.8780,2.2528,P=0.0002,0.0263）.（3）The two groups of patients with ureteral fistula（P=0.5039）,vesicovaginal fistula（P=0.3639）,wound healing（P=0.5182）,lower extremity deep venous thrombosis（P=0.4818） complications had no significant difference.（4）The positive rate of the observation group of lymph nodes（χ2=8.2005,P=0.0000）,parametrial infiltration rate（χ2=8.1553,P=0.0000） was significantly lower than the control group,the difference was statistically significant.Two groups of patients with deep myometrial invasion rate（χ2=0.0991,P=0.7516）,the incidence of cancer embolus（χ2=0.0130,P=0.9176） compared to no statistical significance.Conclusion The effect of neoadjuvant chemotherapy on cervical squamous cell carcinoma is better than that of adenocarcinoma.Compared with the direct for radical resection of cervical cancer,neoadjuvant chemotherapy combined with radical resection of cervical cancer patients for the treatment of stage IB2-ⅡB cervical cancer,operation time and blood loss are lower,node positive and parametrial invasion and postoperative pathologic risk factors in lymph node also can get better effect.
作者
余鸿标
唐杰
杜敏
罗光楠
王琼
Yu Hongbiao Tang Jie Du Min Luo Guangnan Wang Qiong(Gynecology Department, the People＇s Hospital of Luohu District of Shenzhen, Shenzhen 518001, China)
出处
《中国综合临床》
2017年第4期360-363,共4页
Clinical Medicine of China
关键词
新辅助化疗
宫颈癌根治术
IB2~ⅡB期
宫颈癌
鳞癌
腺癌
Neoadjuvant chemotherapy
Radical resection of cervical cancer
IB2-ⅡB stage
Cervical carcinoma
Squamous cell carcinoma
Adenocarcinoma
