The Study On Diagnosis And Treatment For Cervical Cancer And The Relevant Factors Of Recurrent Or Uncontrolled Cervical Cancer

Cervical cancer is the most frequently diagnosed gynecologic malignancy as well as the most easily founded malignancy at early stage in women, there is a very high mortality rate. Therefore, early diagnosis, accurate clinical staging and reasonable treatment are especially important. In this study, we sought to explore the staging, neoadjuvant chemotherapy for cervical cancer as well as the relevant clinical and pathological factors of recurrent or uncontrolled cervical cancer.CLINICAL STUDY OF THE STAGING OF CERVICAL CANCER BY MRIObjective:To investigate the significance of MRI staging for cervical cancer. Methods:Before surgery, MRI was carried out for all the240patients with histologically confirmed cervical cancer. MRI staging was in consistent with FIGO standard. The results of the all patients were compared with the histopathologic findings after surgery. Results:MRI had an accuracy of84.16%in determining clinical stage of cervical cancer. In distinguishing parametrical invasion, the sensitivity and specificity as well as the accuracy was91.80%,95.70%and0.87correspondingly. In determining pelvic lymph node metastasis, the sensitivity, the specificity and the accuracy were85.10%,98.96%and0.84respectively. The accuracy of MRI in differentiating localized and extent of tissue invasion in the paracervical was88.75%. While clinical physical examination only had an accuracy of67.08%in determining clinical stage of cervical carcinoma. In distinguishing parametrical extension, the sensitivity, the specificity and the accuracy were67.21%,92.74%and0.60respectively. Conclusion:1. MRI compared to clinical physical examination, the former is more accurate in determining stage of cervical cancer, and has a higher sensitivity、specificity and accuracy in differentiating parametrical extension.2. MRI makes up for the weakness of clinical physical examination, which has a high accuracy in determining pelvic lymph node metastasis, stroma invasion and uterus invasion.3. MRI examination makes cervical cancer staging more objective and accurate, which avoids the possible deviation of the clinical staging. The combination of MRI and clinical staging is beneficial in planning treatment and prognosis assessment. EVALUATION OF CLINICAL EFFICIENCY OF TWO NEOADJUVANT CHEMOTHERAPY SCHEMES IN CERVICAL CANCERObjective:To compare the effects, adverse reaction and survival rates of the two neoadjuvant chemotherapy schemes for cervical cancer. Methods:The clinical data of125patients with stage Ⅰ b2～Ⅱ b cervical cancer from January,2006to December,2010were reviewed. The patients were randomized into2groups before chemotherapy. Group A(79cases) received the PF scheme with cisplatin and5-Fluorouracil (5-Fu). Group B(46cases) received the TP scheme with cisplatin and docetaxed. The chemotherapy effects, adverse reaction, operation time, operation bleeding volume, lymphocyst incidence, postoperative pathology and survival rates were compared. Results:The total effective rate was87.20%.The effective rate of Group A and Group B were86.06%and89.13%respectively,which was not significantly different (P>0.05). In adverse reaction, there was no significant difference in gastrointestinal reaction between the two groups(P>0.05).Group B was mainly complicated with bone marrow depression, which was significantly different(P<0.05). There was no significant difference in postoperative pathology between the two groups(P>0.05).There were no significant difference in one-year, two-year and three-year survival rates between the two groups(P>0.05). Conclusion:1. The recent effects of these two neoadjuvant chemotherapy schemes were satisfactory and the adverse reactions were minor.2. The two neoadjuvant chemotherapies can control the cervix local lesion, alleviate the parametrial entension, increase the chance of complete resection and reduce the influence of the pathological risk factors on prognosis.3.Both neoadjuvant chemotherapy had clinical significance.PF scheme has a higher survival rate,which is more affordable and applicable. ANALYSIS OF CLINICAL AND PATHOLOGICAL FACTORS OF RECURRENT OR UNCONTROLLED CERVICAL CANCERObjective:To investigate risk factors on recurrent or uncontrolled cervical cancer. Methods:A total number of152cases of cervical cancer confirmed by surgical pathology with completed medical records and follow-up data were collected between January,2000and December2006. The effects of the risk factors including age, FIGO clinical stage, tumor size, pathological type, histological grade, parametrial entension, stroma invasion, vessel invasion and lymph node metastasis on the recurrence of cervical cancer were analyzed The univariate analysis was carried out with Long-rank against multivariate analysis with COX model. Results:The univariate analysis showed that the risk factors including FIGO clinical stage, tumor size, parametrial entension, deep stroma invasion and lymph node metastasis affect the recurrence and being umcontrolled of cervical cancer. The multi-factor analysis showed that independent factors affecting recurrence or being uncontrolled of the cervical cancer were tumor size, parametrial entension and lymph node metastasis. Conclusion:The risk factors affecting recurrence or being uncontrolled of the cervical cancer are interrelated and mutually conditioned. Comprehensive therapy should be emphasized for reducing recurrence of cervical cancer.