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目的:分析宫颈腺鳞癌患者的临床特点、治疗方式。比较不同期别、不同组织分级患者的生存情况。方法:回顾性分析35例宫颈腺鳞癌患者的临床资料。结果:35例患者中位年龄45岁,均以阴道异常出血为首发临床症状。14例ⅠB1期～ⅡA期患者中,有2例ⅡA期患者接受了单纯放疗,另外12例接受了手术治疗,其中2例术后接受了化疗,2例术后接受了单纯放疗,2例术后接受了同步放化疗,其余6例术后未接受辅助治疗。18例ⅡB期～ⅢB期患者中9例接受了单纯放疗,9例接受了同步放化疗。3例Ⅳ期患者均接受了化疗+姑息性放疗。共有10例患者肿瘤复发,复发率为28.6%。中位复发时间为4.5个月。所有患者的3年和5年生存率分别为85.7%和78.0%。Ⅰ、Ⅱ和Ⅲ期患者的5年生存率分别为100%,93.3%和56.3%,3例Ⅳ期患者的生存时间分别为2、10和15个月。高、中分化患者的5年生存率为93.3%,低分化患者的5年生存率为66.9%,但无显著差异(P=0.208)。结论:宫颈腺鳞癌早期患者可以手术治疗或同步放化疗,预后较好。晚期患者应予同步放化疗,预后相对较差,特别是Ⅳ期患者,预后极差。
Objective: To analyze the clinical features and treatment of cervical adenosquamous carcinoma patients. Compare different stages, different organizations grading survival of patients. Methods: The clinical data of 35 cases of cervical adenosquamous carcinoma were retrospectively analyzed. Results: The median age of 35 patients was 45 years old. All of them had vaginal abnormal bleeding as the first clinical symptom. Of the 14 patients with stage IB-IIA, 2 patients undergoing phase IIA received radiotherapy alone and another 12 received surgical treatment, of whom 2 received postoperative chemotherapy, 2 received postoperative radiotherapy alone, and 2 received surgery After receiving concurrent chemoradiotherapy, the remaining 6 patients did not receive adjuvant therapy. Of 18 patients with stage IIB to stage IIIB, 9 received radiotherapy alone and 9 received concurrent chemoradiotherapy. 3 cases of stage Ⅳ patients received chemotherapy + palliative radiotherapy. A total of 10 patients with tumor recurrence rate was 28.6%. The median time to recurrence was 4.5 months. The 3-year and 5-year survival rates of all patients were 85.7% and 78.0%, respectively. The 5-year survival rates in stage I, II and III patients were 100%, 93.3% and 56.3%, respectively. The survival rates in 3 patients with stage IV disease were 2, 10 and 15 months, respectively. The 5-year survival rate was 93.3% in patients with high or moderate differentiation, and 66.9% in poorly-differentiated patients, but no significant difference (P = 0.208). Conclusion: Early cervical adenosquamous carcinoma patients can be treated with surgery or concurrent chemoradiation, the prognosis is good. Patients with advanced should be synchronized radiotherapy and chemotherapy, the prognosis is relatively poor, especially in patients with stage Ⅳ, the prognosis is poor.