摘要
目的探讨术前新辅助化疗治疗ⅠB2期、ⅡA2期老年宫颈癌的临床效果及病理组织形态学改变。方法选取2012年1月-2017年1月南京中医药大学附属南京医院和南京医科大学附属妇产医院收治的老年宫颈癌患者92例作为研究对象,根据治疗方案分为新辅助化疗组与直接手术组。直接手术组接受全麻下广泛性子宫切除术结合盆腔淋巴结与腹主动脉旁淋巴结切除;新辅助化疗组先行紫杉醇+顺铂方案化疗,再接受手术治疗。比较两组患者的手术时间、术中出血量、并发症以及术后病理的形态改变。结果新辅助化疗组的有效率为75.00%,显著高于直接手术组的45.45%(P<0.05)。直接手术组的术中出血量显著高于新辅助化疗组[(799.67±61.27)ml vs(412.48±34.57)ml,P=0.000];直接手术组与新辅助化疗组的手术时长及术后并发症均无统计学差异(P>0.05)。直接手术组的癌组织浸润、脉管侵犯、盆腔淋巴结转移阳性率均高于新辅助化疗组(P均<0.05);直接手术组与新辅助化疗组的宫旁浸润发生率无统计学差异(P>0.05)。结论术前新辅助化疗治疗ⅠB2期、ⅡA2期老年宫颈癌的临床效果显著。
Objective To investigate the clinical effect of preoperative neoadjuvant chemotherapy on patients with stageⅠB2 orⅡA2 cervical cancer and its impact on pathological morphology changes.Methods Ninety-two elderly patients with cervical cancer who were treated in the Second Hospital of Nanjing and Maternity Hospital of Nanjing Medical University from January 2012 to January 2017 were selected as the research subjects.According to the treatment scheme,the patients were divided into neoadjuvant chemotherapy group and direct operation group.The direct operation group received extensive hysterectomy under general anesthesia combined with pelvic lymph node and para aortic lymph node resection,while the neoadjuvant chemotherapy group received paclitaxel plus cisplatin chemotherapy before receiving surgical treatment.The treatment efficacy,operating time,intraoperative blood loss,complications and postoperative pathologic morphology changes of the two groups were compared.Results Neoadjuvant chemotherapy was effective in 75%patients,which was significantly higher than that of the direct operation group(45.45%)(P<0.05).The intraoperative blood loss in the direct operation group was significantly higher than that in the neo-adjuvant chemotherapy group(P<0.05).In the direct operation group,the incidence of the cancer infiltration,intravascular invasion and pelvic lymph node metastasis were all significantly higher than those of the neoadjuvant chemotherapy group(P<0.05).However,there was no significant difference in operative time,postoperative complications and the incidence of para uterine infiltration between the direct operation group and the neoadjuvant chemotherapy group(P>0.05).Conclusion Preoperative neoadjuvant chemotherapy is effective in improving the clinical outcomes for stageⅠB2 and stageⅡA2 cervical cancer in elderly patients.
作者
刘兰侠
汤永峰
刘杜先
LIU Lanxia;TANG Yongfeng;LIU Duxian(Department of Pathology,The Second Hospital of Nanjing,Nanjing University of Chinese Medicine,Nanjing 210003,Jiangsu Province,China;Department of Pathology,Maternity Hospital of Nanjing Medical University,Nanjing 210003,Jiangsu Province,China)
出处
《解放军医学院学报》
CAS
2019年第9期852-855,共4页
Academic Journal of Chinese PLA Medical School
关键词
新辅助化疗
宫颈癌
病理形态
neo-adjuvant chemotherapy
cervical carcinoma in the elderly
pathological morphology
