| Background:Cervical cancer is the highest cancer incidence rate of gynecologic malignant tumors worldwide. In recent years,the incidence is an upward trend, and recurrent cervical cancer is the biggest problem in the treatment of cervical cancer, seriously affected the survival time of patients with cervical cancer in our country.Factors associated with the prognosis of cervical cancer has been the focus of clinical research. Studies have shown that IL-6 and platelet affected tumor prognosisObjective: To investigate the recurrent squamous carcinoma of the cervix and the clinical pathological characteristics,the expression of IL-6 in cancer tissue and peripheral blood platelet count in recurrent squamous carcinoma of the cervix and its effect on the prognosis, and provide scientific basis for clinical intervention and treatment decision, reasonable factors of recurrence and prognosis of squamous carcinoma of the cervix.Methods: A retrospective analysis of Second Affiliated Hospital of Dalian Medical University between 2009.1.-2013.12 admitted 51 cases of recurrent squamous carcinoma of the cervix patients, with a recurrence free survival(RFS) and overall survival(OS) for recording parameters.Detect the expression of IL-6 by immunohistochemical method in cervical carcinoma and counts the detection of platelet count in peripheral blood confirmed by full automatic blood cell analyzer. Log-rank test was used to compare the survival rate, survival curves were plotted by Kaplan-meier, using Cox regression model for multivariate analysis, effect analysis of clinical and pathological features, IL-6 and platelet in patients with RFS and OS; analysis of the correlation between the clinical and pathological characteristics of IL-6 cancer tissues and peripheral blood platelet count in patients with recurrent squamous carcinoma of the cervix of the party test card used; linear correlation analysis using Pearman for the expression of IL-6 and platelet count..Result:51 patients, aged 27-74, were women.The median age was 51 years old.The median PFS was 9.20 months(1-60.75 months).The median OS was 20.11 months(6.39-63.93 months). 51 patients with 1 year survival rate was 84.31%, 1.5 year survival rate was 60.78%, 2 year survival rate was 39.22%, 2.5 years survival rate was 27.45%, 3 year survival rate was 7.8%.1.The positive percentage IL-6 in normal cervical tissue was 20%, the positive rate of IL-6 in cervical cancer tissue was 88.24%, statistically significant differences in expression(P=0.000).The level of IL-6 expression in cervical cancer tissues relate to metastatic sites associated with thrombus vascular cancer(P=0.039 and P=0.024).But IL-6 isn’t connected with age,clinical stage,degree of differentiation,RFS,tumor size, lymph node metastasis,depth of invasion.2. Peripheral blood increased platelet associate with clinical staging and metastasis(P=0.046 and P=0.044). Age, degree of differentiation, RFS, vascular invasion, tumor size, lymph node metastasis, infiltration depth associated with increased platelet in peripheral blood had no statistical significances.3.On platelet levels and IL-6 expression using Pearman rank correlation analysis, platelet count and IL-6 expression are highly correlated(r=0.469, P=0.000).4.Single factors have significant effect on the patients of recurrence squamous carcinoma of the cervix with RFS: clinical stage(P=0.000), tumor size(P=0.000), depth of invasion(P=0.014), initial treatment: operation treatment(P=0.022), chemical treatment(P=0.016), platelet count(P= 0.028) and IL-6 expression(P=0.032). Age, degree of differentiation, vascular invasion, lymph node metastasis, recurrence site, initial treatment: radiation therapy had no statistical significance for RFS.Clinical stage(P=0.000), depth of invasion(P=0.004), chemical treatment(P=0.028), platelet count(P=0.031) and the expression of IL-6(P=0.035) were independent prognostic factors for RFS.5.For the median OS, clinical stage(P=0.001), recurrence free survival(P=0.000), tumor size(P=0.012), depth of invasion(P=0.014), initial treatment: operation treatment(P=0.044) and platelet count(P=0.042) with statistical significance. Age, degree of differentiation, vascular invasion, lymph node metastasis, recurrence, site of recurrence before radiation therapy before relapse, whether for chemical treatment, the expression of IL-6 had no statistical significance.Clinical stage(P=0.001), RFS(P=0.007), depth of invasion(P=0.006) and platelet count(P=0.012) were independent prognostic factors for OS.Conclusion:1.The expression of IL-6 in cervical squamous cell carcinoma increased, initial peripheral blood platelets increased suggesting increased risk of cervical squamous cell carcinoma metastasis, the expression of two highly correlated.2.Newly diagnosed clinical stage, depth of invasion, chemotherapy, peripheral blood platelet count and IL-6 expression were independent prognostic factors for recurrence squamous cell cervical carcinoma RFS. The clinical stage, recurrence free survival independent prognostic factors, infiltration depth and peripheral blood platelet count for recurrent squamous cell cervical carcinoma OS. |
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