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目的探讨宫颈癌皮肤转移患者的临床特点、诊治过程及预后。方法我院自2006年6月至2011年6月共收治宫颈癌患者574例,其中5例确诊为宫颈癌皮肤转移。收集该5例患者的临床、病理及随访资料,并分析其临床特点、诊治过程及预后。结果宫颈癌皮肤转移的发生率为0.87%(5/574),均为宫颈癌ⅡA~ⅢB期患者。其中,4例在确诊宫颈癌并完成治疗后的随访过程中发现皮肤转移;1例为初治患者,入院后1个月发现逐渐增大的皮肤结节,手术切除后确诊为皮肤转移。4例患者合并肺部、骨骼等其他部位的转移。4例患者行手术完整切除皮肤病灶,术后1例因合并有多发骨转移且骨痛明显接受核素治疗,1例行全身化疗,2例仅接受对症支持治疗。1例患者因头皮转移病灶向内侵犯颅骨,无法行手术切除,行穿刺检查诊断转移后接受调强适形放疗。随访中3例患者死亡,另2例诊断宫颈癌皮肤转移分别为3个月、5个月,仍存活。结论宫颈癌皮肤转移发生率低,通常合并有其他脏器的转移,治疗较困难,预后较差。
Objective To investigate the clinical features, diagnosis, treatment and prognosis of cervical cancer patients with skin metastasis. Methods A total of 574 cases of cervical cancer were treated in our hospital from June 2006 to June 2011, of which 5 cases were diagnosed as cervical cancer metastasis. Collect the clinical, pathological and follow-up data of the 5 patients and analyze their clinical features, diagnosis and treatment process and prognosis. Results The incidence of cervical cancer skin metastasis was 0.87% (5/574), all of which were stage ⅡA-ⅢB cervical cancer patients. Among them, 4 cases were diagnosed as cervical cancer and follow-up after treatment was found in the process of skin metastasis; one case of newly diagnosed patients, one month after admission, gradually increased skin nodules were found after surgical resection was diagnosed as skin metastasis. 4 patients with lung, bone and other parts of the transfer. Four patients underwent complete resection of the skin lesion. One patient was treated with radionuclide due to multiple bone metastases and bone pain after operation. One patient received systemic chemotherapy and two patients received symptomatic supportive care. One patient had invaded the skull due to scalp metastases and was unable to undergo surgical resection. The patient underwent needle biopsy after diagnosis of metastasis. Three patients died during the follow-up, and the other two cases diagnosed cervical cancer skin metastasis were 3 months, 5 months, still alive. Conclusions Cervical cancer has a low incidence of skin metastasis, usually accompanied by metastasis of other organs, the treatment is more difficult and the prognosis is poor.