| 冯明明,周 林,张 洁,傅士龙,程文俊.宫颈癌术后复发的危险因素及SCC-Ag、HR-HPV对复发的预测价值分析[J].,2020,(8):1583-1587 |
| 宫颈癌术后复发的危险因素及SCC-Ag、HR-HPV对复发的预测价值分析 |
| The Risk Factors of Postoperative Recurrence of Cervical Cancer and the Predictive Value of SCC Ag and HR-HPV |
| 投稿时间：2019-11-20 修订日期：2019-12-14 |
| DOI：10.13241/j.cnki.pmb.2020.08.041 |
| 中文关键词: 宫颈癌 复发 鳞状细胞癌抗原 高危型人乳头瘤病毒 |
| 英文关键词: Cervical cancer Recurrence Squamous cell carcinoma antigen High risk human papillomavirus |
| 基金项目:江苏省医学创新团队项目(CXTDA2017008)；国家自然科学基金项目 (31401225) |
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| 中文摘要: |
| 摘要 目的：分析宫颈癌术后复发的危险因素，探讨鳞状细胞癌抗原（SCC-Ag）、高危型人乳头瘤病毒（HR-HPV）对宫颈癌术后复发的预测价值。方法：对2010年1月至2017年12月我院收治的宫颈癌患者300例进行回顾性分析，收集其临床资料，所有患者随访2年，定期检测SCC-Ag表达情况及HR-HPV感染情况，根据患者复发情况分为复发组与未复发组，应用单因素和多因素Logistic回归分析宫颈癌术后复发的危险因素，以病理诊断为金标准，分析SCC-Ag、HR-HPV对宫颈癌术后复发的预测价值。结果：随访期间出现12例失访，300例患者中完成随访288例，出现复发40例，未复发248例。单因素分析结果显示宫颈癌术后复发与肿瘤直径、分化程度、肿瘤间质浸润情况、临床分期、淋巴结转移、SCC-Ag阳性表达、HR-HPV持续感染有关（P<0.05），而与发病年龄、体质量指数（BMI）、吸烟史、性行为开始年龄、宫颈癌家族史、病理类型、术后放化疗无关（P>0.05）。多因素Logistic回归分析显示：中低分化、深肌层浸润、临床分期IIA1-IIA2期、有淋巴结转移、SCC-Ag阳性、HR-HPV持续感染是宫颈癌术后复发的危险因素（P＜0.05）。SCC-Ag联合HR-HPV预测宫颈癌术后复发的灵敏度、特异度、阳性预测值、阴性预测值分别为92.50%、87.50%、54.41%、98.64%。结论：中低分化、深肌层浸润、临床分期IIA1-IIA2期、有淋巴结转移、SCC-Ag阳性、HR-HPV持续感染是宫颈癌术后复发的危险因素，SCC-Ag联合HR-HPV预测宫颈癌术后复发具有一定价值，值得临床关注。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the risk factors of postoperative recurrence of cervical cancer, and to investigate the predictive value of serum squamous cell carcinoma antigen (SCC-Ag) level and high-risk human papillomavirus (HR-HPV) infection for postoperative recurrence of cervical cancer. Methods: 300 cases of cervical cancer in our hospital from January 2010 to December 2017 were analyzed retrospectively. Clinical data was collected, and all patients were followed up for 2 years. The expression of SCC-Ag and the infection status of HR-HPV were tested regularly, and patients were divided into the recurrence group and the non-recurrence group according to the recurrence situation. Univariate and multivariate Logistic regression analysis was used to analyze the risk factors of postoperative recurrence of cervical cancer, and taking pathological diagnosis as the gold standard, the predictive value of SCC-Ag and HR-HPV for postoperative recurrence of cervical cancer were analyzed. Results: During the follow-up period, 12 patients were lost to follow-up and 288 of the 300 patients were followed up, 40 cases recurred, 248 cases did not recurred. Univariate analysis showed that postoperative recurrence of cervical cancer was related to tumor diameter, differentiation degree, tumor stromal infiltration, clinical stage, Lymph node metastasis, SCC-Ag positive expression, HR-HPV persistent infection(P<0.05). However, it was not associated with age of onset, Body mass index(BMI), smoking history, sexual behavior start age, family history of cervical cancer, pathological type, postoperative radiotherapy and chemotherapy (P>0.05). Multivariate logistic regression analysis showed that low differentiation, deep myometrial invasion, clinical stage IIA1-IIA2, lymph node metastasis, SCC-Ag positive, HR-HPV positive were the risk factors of postoperative recurrence of cervical cancer (P<0.05). The sensitivity, specificity, positive predictive value and negative predictive value of SCC-Ag combined with HR-HPV were 92.50%, 87.50%, 54.41%, 98.64% respectively. Conclusion: Poor differentiation, deep myometrial invasion, clinical stage IIA1-IIA2, lymph node metastasis, SCC-Ag positive and HR-HPV positive are the risk factors of postoperative recurrence of cervical cancer. The SCC-Ag combined with HR-HPV has a certain value in predicting postoperative recurrence of cervical cancer, which is worthy of clinical attention. |
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