Clinical Features And Prognosis Of Cervical Adenocarcinoma And Adenosquamous Carcinoma:A Meta-Analysis

Objective: To compare the clinicopathological features and prognosis of cervical adenosquamous carcinoma(AC)and cervical adenosquamous carcinoma(ASC)by using Meta-analysis method,and to provide evidence-based basis for the treatment of cervical adenosquamous carcinoma(ASC).Methods:To retrieve Chinese biomedical literature database(CBM),China National Knowledge Internet(CNKI),Wangfang database,VIP,Pub Med,The Cochrane Library and Embase database of cervical adenocarcinoma and gland scale cancer clinical pathologic features and prognosis of comparative literature,choose to build libraries to be published on December 31,2020 randomized controlled studies of AC and ASC or design good non randomized controlled study of relevant literature,and a complete source of information. By two researchers extracted data,and according to the included in the exclusion criteria to collect relevant case-control Study(Case-Control Study,CCS)literature,use the Meta analysis method to comprehensive analysis of count data(relative risk,RR))relative risk as the factors affecting the effect of value,with RR,95% Confidence Interval(the Confidence Interval,CI)said the effect size range.Seven factors were identified:(1)age,(2)tumor size,(3)FIGO stage,(4)tissue grade,(5)depth of invasion,(6)lymph node metastasis.(7)5-year survival rate;The available data information was included into the experimental data of the study,and the Rev Man 5.3 software provided by the Cochrane Collaboration was used for statistical analysis.Results: A total of 8 studies were included,all of which were case-control studies.In this study,1250 patients with cervical adenocarcinoma and 411 patients with cervical adenossquamous carcinoma were included.Meta-analysis of the 8 included literatures showed that compared with ASC,(1)there was no statistically significant difference in the proportion of patients with the median age of onset of cancer between the two groups(SMD=0.17,95%CI: 0.01-0.33,P > 0.05).(2)There was a statistically significant difference in the incidence of tumor diameter large than 4cm between the two groups.The results showed that tumor diameter large than 4cm in AC group;The proportion of 4cm patients was lower than that of ASC group(RR=0.76,95%CI=0.63-0.92,P <0.05).Meta-analysis results showed no statistically significant difference between AC and ASC in the proportion of patients with tumor diameter large than 4cm(RR=1.02,95%CI:0.94-1.11,P > 0.05).(3)There was a statistically significant difference in the incidence of FIGO stage I between the two groups.The results showed that the incidence of FIGO stage I in AC patients was higher than that in ASC patients.(RR=1.01,95%CI=1.11-1.22,P < 0.05);There was no significant difference in the incidence of FIGO stage II between the two groups(RR=0.78,95%CI: 0.64-0.95,P > 0.05).There was no significant difference in the incidence of FIGO stage IIb-IV between the two groups(RR=0.78,95%CI: 0.52-1.17,P > 0.05).(4)There was no significant difference in the incidence of high differentiation between the two groups(RR=1.34,95%CI: 1.00-1.81,P > 0.05).There was statistical significance in the incidence of poorly differentiated tumors between the two groups.The results showed that the proportion of poorly differentiated patients in AC was significantly lower than that in ASC(RR=0.57,95%CI=0.47-0.69,P < 0.05).(5)There were statistically significant differences in the incidence of cervical interstitial infiltration of large than 1/2cm or less than 1/2cm between the two groups.The results showed that the proportion of cervical interstitial infiltration more than 1/2cm in AC patients was lower than that in ASC(RR=0.78,95%CI: 0.71-0.86,P < 0.05).The proportion of AC patients with cervical interstitial infiltration less than 1/2cm was higher than that of ASC patients(RR=1.27,95%CI: 1.11-1.47,P < 0.05).(6)Compared with ASC,the Meta analysis showed no significant difference in the incidence of lymph node metastasis between the two groups(RR=0.85,95%CI: 0.67-1.08,P > 0.05).(7)There was no significant difference in 5-year survival rate between AC and ASC(OR=1.29,95%CI: 0.98-1.71,P > 0.05).Conclusions:The proportion of cervical adenocarcinoma and adenosquamous carcinoma of cervix with tumor diameter larger than 4cm was different.The proportion of patients with cervical interstitial infiltration greater than 1/2cm and low tumor differentiation was significantly lower than that of patients with cervical adenosquamous carcinoma.There was no significant difference in lymph node metastasis and 5-year survival rate between adenocarcinoma and adenosquamous carcinoma of cervix.