年龄与宫颈癌预后状况分析

Analysis of correlation between age and prognosis in patients with cervical cancer

摘要:

目的探讨宫颈癌发病年龄与临床预后的关系。方法选取2010 年1 月-2016 年6 月该院收治的宫颈癌患者425 例。平均随访（38.9±13.7）个月，分为年轻组（≤35 岁）、中年组（>35～<65 岁）及老年组（≥65岁）。分析病理分级、临床分期及放疗等临床资料。结果在临床分期方面，≤35 组多为Ⅱ期，Ⅳ期的比例最少，同样结果也表现在肿瘤大小方面。在放疗方面，≤35 组未接收放疗比例达到58.8%，高于中年组的41.2%以及≥65 组28.2%。在5 年总体生存率方面，≤35 组患者总体生存（90.2%）高于≥65 组（62.4%），风险比为4.877（P =0.000）；同时放疗能提高年轻患者的总体生存率，其风险比为0.08，差异有统计学意义（P =0.017）。多因素 分析结果表明年龄、分化程度、临床分期以及放疗均是影响宫颈癌预后的独立危险因素。结论年龄是影响宫颈癌患者预后的独立危险因素之一，年轻患者预后优于老年患者，同时放疗能改善年轻宫颈癌患者的总生存率。

Abstract:

Objective To analyze the correlation between age and prognosis in patients with cervical cancer. Methods At an average follow-up of (38.9 ±13.7) months, 425 patients obtained in our hospital from January 2010 to June 2016 were divided into young group (≤35 y); middle aged group (36-64 y) and old group (≥65 y). Clinical data such as pathological grade, clinical stage and radiotherapy were analyzed. Results Patients with age ≤35 y were more likely to be in stage Ⅱ, but less likely to be in stage Ⅳ. So did tumor size. Furthermore, more patients in the young group (58.8%) did not receive radiotherapy compared with those in the middle aged group (41.2%) and the old group (28.2%). At the 5 years' follow-up, patients with age ≤35 y had a 5-year overall survival (OS) of 90.2%, while the patients in the old group had an OS of 62.4%(HR = 4.877,P = 0.000). In addition, the radiotherapy could dramatically improve the overall survival of the younger patients (HR = 0.080,P = 0.017). Multivariate analysis of OS showed that age, grade, stage and history of radiotherapy were independent risk factors. Conclusions Age is an independent prognostic factor of cervical cancer, and the younger patients (≤35 y) have a better prognosis than the elder ones. Moreover,radiotherapy can improve the overall survival in the younger patients.