目的分析腹腔镜手术治疗宫颈癌临床预后的影响因素,并提出预防措施以改善患者的预后。方法回顾性分析98例宫颈癌患者的临床资料,并根据实体肿瘤疗效评判标准对患者的疗效进行评价,将完全缓解、部分缓解、疾病稳定的患者纳入良好组,疾病进展患者纳入不良组。对患者的年龄、病理类型、肿瘤分期、肿瘤直径、淋巴结转移、淋巴细胞/单核细胞比值(LMR)、术中出血量、盆腔感染等指标进行统计,先进行单因素分析,对单因素分析有统计学意义的指标再运用多因素Logistic回归分析法分析宫颈癌患者疗效的影响因素。结果良好组78例(79.59%),不良组20例(20.41%)。单因素分析结果显示,两组患者的肿瘤分期、肿瘤直径、淋巴结转移、LMR比较,差异均有统计学意义(均P<0.05)。Logistic回归分析发现:肿瘤分期>ⅠB2、肿瘤直径>4 cm、淋巴结转移、LMR≥2.01是腹腔镜手术治疗宫颈癌临床预后的独立危险因素(均P<0.05)。结论肿瘤分期>ⅠB2、肿瘤直径>4 cm、淋巴结转移、LMR≥2.01是影响腹腔镜手术治疗宫颈癌临床预后的重要因素,应根据这些因素给予相应处理。
ObjectiveTo analyze the influencing factors of clinical prognosis in cervical cancer treated by laparoscopic surgery, and to put forward the precautions measures to improve the prognosis of patients. MethodsThe clinical data of 98 patients with cervical cancer were analyzed retrospectively, and the therapeutic efficacy was evaluated according to the evaluation criteria for solid tumor efficacy. Patients with complete remission, partial remission or stable disease were enrolled in the good group, whereas patients with disease progression were enrolled in the poor group. The indicators, including age, pathological type, tumor stage, tumor diameter, lymph node metastasis, lymphocyte to monocyte ratio (LMR), intraoperative blood loss, and pelvic infection, were counted, an univariate analysis was conducted, and then multivariate logistic regression analysis was applied to the indicators with statistical significance revealed by univariate analysis to analyze the influencing factors of efficacy in patients with cervical cancer. ResultsThere were 78 (79.59%) cases in the good group and 20 (20.41%) cases in the poor group. Univariate analysis results revealed that there were statistically significant differences in tumor stage, tumor diameter, lymph node metastasis, LMR between the two groups. Logistic regression analysis revealed that tumor stage >ⅠB2, tumor diameter >4 cm, lymph node metastasis, and LMR≥2.01 were the independent risk factors for clinical prognosis of cervical cancer treated by laparoscopic surgery(all P<0.05). ConclusionTumor stage>ⅠB2, tumor diameter >4 cm, lymph node metastasis, and LMR≥2.01 are the important factors affecting clinical prognosis of cervical cancer treated by laparoscopic surgery, in accordance with which corresponding treatments should be performed.