Prognostic Factors Of Cervical Adenocarcinoma:A Meta Analysis And Clinical Research

Cervical cancer is one of three major malignant tumor of department of gynaecology,recently the incidence of the cervical cancer in developed countries has declined,but still at a higher levels in developing countries,and showing a trend of getting younger and younger.The proportion of adenocarcinoma in cervical cancer increased year by year,and it appears poor prognosis compared with squamous cell carcinoma.The incidence of younger,pathological changes of the cervical adenocarcinoma caught the attention of some scholars.This research is divided into two parts to discuss the prognostic factors of cervical adenocarcinoma:(1)A meta analysis of prognostic factors of cervical adenocarcinoma;(2)Analysis of prognostic factors in patients with surgically-treated of cervical adenocarcinoma.Objective:To investigate the prognosis factors of cervical adenocarcinoma.Method:By searching the MEDLINE,CNKI and WangFang Database(1993.1～2003.1)at hone and abroad about prognostic factors of cervical adenocarcinoma,then taking a quadratic search on the references,we run a quality assessment and Meta-analysis on those met the criteria randomized controlled trial.Result:Seventeen studies were included,the 5-year survival rate was for outcome variable.The pooled OR and 95%CI by meta-analysis were as follows:Tumor size 0.29(0.24,0.36),LVSI 0.12(0.08,0.19),deep stromal invasion 0.27(0.16,0.45),parametrial involvement 0.13(0.06,0.25),resection margin status 0.13(0.03,0.53),lymph node metastasis 0.12(0.09,0.16),grade of differentiationa 0.42(0.28,0.62)and FIGO stage 0.28(0.22,0.35).Conclusion:Tumor size,LVSI,deep stromal invasion,parametrial involvement,resection margin status,lymph node metastasis,grade of differentiationa and FIGO stage were prognostic factors of cervical adenocarcinoma.Objective:To observe the clinicopathological characteristics and analyze the prognosis factors of patients of cervical adenocarcinoma with surgically-treated.Method:Retrospectively reviewed the clinicopathological characteristics of 204 patients with cervical adenocarcinoma who diagnosed and underwent surgery in the affiliated cancer hospital of guangxi medical university between December 1992 and December 2012.Result:Compared with squamous carcinoma,patients with adenocarcinoma had higher rate of lymphatic metastasis(P=0.008).Univariate analysis showed that pathological type of mucinous adenocarcinoma,deep stromal invasion and lymph node metastasis leaded to poor prognoses(P<0.05).Multivariate analysis showed that only lymph node metastasis was independent risk factor that influence the prognosis of cervical adenocarcinoma(P=0.001).Conclusion:Compared with squamous carcinoma,patients with adenocarcinoma had higher rate of lymphatic metastasis.Lymph node metastasis was independent prognosis-related factors.