摘要
Abstract
Objective:To explore the clinical characteristics,pathological features,treatment and prognosis of non-HPV-associated cervical adenocarcinoma(NHPVA),to improve the understanding of the disease and provide more reference for clinical diagnosis and treat-ment.Methods:The data of 84 patients with NHPVA in the First Affiliated Hospital of Zheng-zhou University from January 2019 to December 2023 were retrospectively analyzed.Kaplan-Meier test and Log-rank test were used to analyze the relationship between related factors and prognosis.Results:The median age of 84 patients was 50 years old(29～71years).The main clinical manifestations were abnormal vaginal bleeding and contact bleeding.Among the 84 pa-tients,there were 38 cases of gastric-type adenocarcinoma,17 cases of clear cell adenocarcino-ma,2 cases of mesonephric adenocarcinoma,and 27 cases of endometrioid adenocarcinoma.Ac-cording to FIGO(2018)stage,there were 36 patients(42.86%)in stage 1,14 patients(16.67%)in stage Ⅱ,29 patients(34.52%)in stage Ⅲ,and 5 patients(5.95%)in stageⅣ.There were 37 cases(44.05%)with low differentiation,60 cases(71.40%)with deep in-terstitial infiltration,30 cases(35.71%)with lymphatic metastasis,and 8 cases(9.52%)with ovarian metastasis.The overall survival rates of the first and fifth years were 91.3%and 71.7%respectively.The K-M analysis showed that FIGO stage,degree of tumor differentiation,degree of interstitial infiltration,lymphatic metastasis,and ovarian metastasis were related to the prognosis of the disease,while age,pregnancy times,delivery times,abortion times,whether menopause,adjuvant therapy,and pathological subtypes had no significant influence on the prognosis.Conclusion:The biological behavior of NHPVA is relatively hidden.The clinical manifestations and signs are atypical,the diagnosis is mostly advanced,and the positive rate of cervical cancer screening is low.MRI and immunohistochemistry are very important for the dif-ferentiation of the disease.Surgery is the main treatment,and preservation of the ovaries is not recommended.Patients with late stage,low differentiation,deep interstitial infiltration,lymphatic metastasis and ovarian metastasis tend to have poor prognosis.关键词
宫颈腺癌/非HPV相关性/临床特点/治疗/预后Key words
Endocervical adenocarcinoma/Non-HPV-associated/Clinical features/Treatment/Prognosis分类
临床医学
