The application value of Silva invasion pattern in cervical adenocarcinoma
Objective To analyze the pathological parameters and survival information of Silva invasion pattern classification in patients with endocervical adenocarcinoma(EAC),and to explore the value of Silva invasion pattern classification in individualized diagnosis and treatment and prognosis evaluation of EAC patients.Methods A total of 112 patients who underwent gynecological surgery and pathologically diagnosed as primary EAC in the First Affiliated Hospital of Xi'an Jiaotong University from January 2008 to December 2017 were selected as the research subjects.According to the Silva invasion pattern classification standard,they were divided into Silva A pattern,Silva B pattern,and Silva C pattern.The survival status of the patients was obtained by follow-up methods such as telephone,and the pathological parameters and survival analysis results of the three Silva classifications were compared.Results Silva classification was associated with International Federation of Gynecology and Obstetrics(FIGO)stage,lymphovascular space invasion,lymph node metastasis,recurrence and death.Pattern C had a higher FIGO stage,a higher risk of lymphovascular space invasion and lymph node metastasis,and was more likely to have recurrence and death(x2=15.035-23.518,P＜0.05);The median 5-year overall survival(OS)of pattern A patients was 66 months,with an average of(67.29±27.67)months and a 5-year OS rate of 53.66％.The median progression free survival(PFS)was 62 months,with an average of(63.24±31.15)months and a 5-year PFS rate of 51.22％;The median OS of pattern B patients was 53 months,with an average of(63.73±30.69)months and a 5-year OS rate of 40.00％.The median PFS was 49 months,with an average of(58.35±33.32)months and a 5-year PFS rate of 37.50％;The median OS of pattern C patients was 47 months,with an average of(54.72±30.93)months and a 5-year OS rate of 27.59％.The median PFS was 36 months,with an average of(41.23±30.42)months and a 5-year PFS rate of 17.24％.Survival analysis showed that the Silva C pattern had the most obvious decline in the curve,the shortest survival time,and was prone to recurrence;While there was no statistically significant difference in OS and recurrence time between Silva A and B patterns(P＞0.05).Conclusion The Silva invasion pattern classification is statistically correlated with FIGO stage,lymphovascular space invasion,lymph node metastasis,recurrence,and death.Compared with A and B patterns,Silva C pattern has a worse prognosis.
万方数据
维普
