宫颈癌前病变子宫切除术后再发阴道残端癌临床分析

Clinical analysis of vaginal stump cancer after hysterectomy for cervical intraepithelial neoplasia

摘要:

目的： 探讨宫颈癌前病变（cervical intraepithelial neoplasia，CIN）子宫切除术后再发阴道残端癌患者的合理诊治方案。方法： 回顾性分析2011年1月至2019年12月于重庆大学附属肿瘤医院妇科肿瘤中心收治的24例宫颈癌前病变行全子宫切除术后再发阴道残端癌患者的临床资料。患者确诊为阴道残端癌时平均年龄为（55.83±7.64）岁；全子宫切除术后至发生阴道残端癌的平均间隔时间为（54.83±36.23）个月；83.33%（20/24）的患者高危HPV阳性。2例患者采用单纯手术治疗，7例患者采用手术联合放疗±化疗，11例患者采用放化疗，4例患者放弃治疗。结果： 20例患者治疗后进入随访，1例患者失访，平均随访时间为（44.95±32.98）个月，19例患者中2例死亡，总生存率为89.47%。结论： CIN子宫切除术后阴道残端癌重在预防，治疗需个体化。

Abstract:

Objective: To explore a reasonable treatment for patients with vaginal stump cancer after hysterectomy for cervical intraep ithelial neoplasia (CIN). Methods: A retrospective analysis was made on the clinical data of 24 patients who were diagnosed with vaginal stump cancer after hysterectomy for CIN from January 2011 to December 2019 in Chongqing University Cancer Hospital. The mean age was (55.83±7.64) years. The duration from the first operation to vaginal stump cancer was (54.83±36.23) months. And 83.33% (20/24) of the patients were high-risk HPV positive. Among them, 2 patients were treated with surgery alone, 7 patients with surgery combined radiation±chemotherapy, 11 patients with radiation and chemotherapy, and 4 patients gave up treatment. Results: Twenty patients were followed up after treatment. One patient was lost. The mean follow-up time was (44.95±32.98) months, 2 of 19 patients died, and the overall survival rate was 89.47%. Conclusion: Prevention is more important for patients with vaginal stump cancer after CIN, and treatment should follow the principle of individualization.