The Clinicopathologic Characteristics And Analysis Of Prognostic Factors Of Endocervical Carcinoma

Objective: Endocervical cancer is a rare type of cervical cancer.Because of the lack of typical and early clinical symptoms,as hidden lesions,it is often neglected in clinical practice.This study aims to explore the clinicopathologic characteristics and the prognostic factors of endocervical carcinoma by comparing the clinicopathologic data between patients with endocervical cancer and non-endocervical cancer,and further to do prognostic analysis.Thus to improve the prognosis of endocervical cancer by early identification and aggressive treatment.Methods: The clinicopathologic data of 478 cervical cancer patients was collected,who underwent surgery in the Fourth Hospital of Hebei Medical University from August 1st,2008 to August 30 th,2011.Among them,53 cases were endocervical cancer patients,and 425 cases were non-endocervical cancer patients.The clinicopathologic characteristics were compared between two groups,and the prognostic factors of the two groups were analyzed using the univariate model and the multivariate regression model.Results:1 Compared with non-endocervical cancer patients,endocervical cancer patients occupied a higher proportion,with non-squamous carcinoma,or diagnostic age over 50,or cervical cancer family history among direct line relatives,or with post-operative treatment.The difference was statistically significant(P<0.05).There were no significant differences about the maternal times,clinical symptoms and clinical stage between two groups.2 Patients with endocervical cancer exhibited significantly larger proportion of non-squamous histology,and endocervical cancer was more likely to develop cervical canal mouth invasion,uterine corpus invasion,deep stromal invasion and parametrial invasion(P<0.05).However,there were no significant difference while compared with non-endocervical cancer about the tumor size after operation,grade of differentiaton,lymphovascular space invasion and lymph node metastasis.3 The 5-year survival rate of endocervical cancer patients and non-endocervical cancer patients were 78.0% and 88.2%,respectively,and the difference was statistically significant(P=0.041).4 In multivariate analysis,tumor diameter after surgery was a significant prognostic factor for 5-year overall survival in the group of patients with endocervical cancer.5 Univariate analysis showed that the predictors of 5-year overall survival in patients with non-endocervical cancer included tumor size,deep stromal invasion,lymphovascular space invasion,cervical canal mouth invasion,parametrial invasion,and lymph node metastasis.Multivariate analysis identified only tumor size and lymph node metastasis as independent predictors.6 The accuracy rate of tumor size before and after surgery was 69.81% in patients with endocervical cancer.And the tumor size after surgery was significantly larger than pre-operation(P=0.001).Conclusions:1 Compared with non-endocervical cancer,patients with endocervical cancer were diagnosed at older age.And the treatments after surgery were often needed.2 Endocervical cancer were more likely to develop cervical canal mouth invasion,uterine corpus invasion,deep stromal invasion and parametrial invasion,and with squamous carcinoma a higher proporation.3 Patients with endocervical cancer experienced signifcantly worse survival outcomes than those with non-endocervical cancer,and was hard to be identified at early stage.Then it needs to strenghthen the identification of endocervical cancer,postoperative management,and follow-up.4 Postoperative tumor size was an independent prognostic factor for endocervical cancer.5 Tumor size,deep stromal invasion,lymphovascular space invasion,cervical canal mouth invasion,parametrial invasion,and lymph node metastasis were related to the prognosis of non-endocervical cancer,and tumor size,lymph node metastasis were independent prognostic factors.