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目的 :探讨手术前血浆D-二聚体(D-dimer,D-D)水平对早期宫颈癌患者手术后复发的影响。方法 :这是个前瞻性研究。对2009年1月1日—2012年12月31日在温州市人民医院进行宫颈癌根治术的165患者进行随访,以宫颈癌复发为终点事件。根据手术前血浆D-D水平分为D-D≥0.50 mg/L组(67例,40.6%)和D-D<0.50 mg/L组(98例,59.4%),Kaplan-Meier法绘制患者的生存曲线,分析影响宫颈癌复发的危险因素。结果 :D-D<0.50 mg/L组有11例患者复发,中位复发时间为36个月,5年无复发生存率为88.8%(87/98);D-D≥0.50 mg/L组有16例患者复发,中位复发时间为25.5个月,5年无复发生存率为76.1%(51/67)。D-D≥0.50mg/L组患者的无复发生存率显著低于<0.50 mg/L组(P=0.028)。淋巴结转移、宫颈癌国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)分期、血浆D-D水平和治疗方法是影响宫颈癌复发的独立危险因素(P值均<0.05)。结论 :手术前血浆D-D水平是影响宫颈癌复发的危险因素。
Objective: To investigate the effect of preoperative plasma D-dimer (D-D) on the recurrence of patients with early stage cervical cancer. Method: This is a prospective study. From January 1, 2009 to December 31, 2012 in Wenzhou People’s Hospital for cervical cancer radicalized 165 patients were followed up for the recurrence of cervical cancer as the end point. According to the preoperative plasma DD level, the survival curves of patients with DD ≥0.50 mg / L (67 cases, 40.6%) and DD <0.50 mg / L (98 cases, 59.4%) were calculated by Kaplan-Meier method. Cervical cancer recurrence risk factors. RESULTS: Eleven patients relapsed with DD <0.50 mg / L, with a median recurrence of 36 months and 88.8% (87/98) at 5 years. In the group with DD ≥ 0.50 mg / L, 16 patients Recurrence, median recurrence time was 25.5 months, 5-year recurrence-free survival rate was 76.1% (51/67). The recurrence-free survival of patients with D-D≥0.50mg / L was significantly lower than that of <0.50mg / L (P = 0.028). Lymph node metastasis, the International Federation of Gynecology and Obstetrics (FIGO) staging, plasma D-D levels and treatment were independent risk factors for cervical cancer recurrence (all P <0.05). Conclusion: Preoperative plasma D-D level is a risk factor for cervical cancer recurrence.