Analysis of characteristics and prognostic factors of radiotherapy and chemotherapy in patients with cervical cancer complicated with reproductive tract infection
Objective To summarize the clinical characteristics of patients with cervical cancer complicated with reproductive tract infection and analyze the prognosis and influencing factors of radiotherapy and chemotherapy.Methods This study was a single-center retrospective cohort study.Patients with cervical cancer complicated with reproductive tract infection who underwent radiotherapy and chemotherapy in Fujian Cancer Hospital from January 2018 to August 2020 were collected.The clinical characteristics of the patients were summarized.The Kaplan-Meier method was used to calculate and compare the progression-free survival(PFS)time and overall survival(OS)time of the two groups of patients.Univariate and multivariate logistic regression analyses were performed on the related factors of prognosis.Results A total of 80 patients were included in this study.The median diagnostic age of the patients was 55.5 years old.The most common symptom was irregular vaginal bleeding.The most common pathological type was squamous cell carcinoma(92.5％,74/80).96.3％(77/80)were from rural areas.13 cases had diabetes(16.3％).All patients were restaged according to the 2018 FIGO staging.Among them,1 case was in stage Ⅱ a(1.3％),26 cases were in stage Ⅱ b(32.5％),12 cases were in stage Ⅲ b(15.0％),32 cases were in stage Ⅲc(40％),5 cases were in stage Ⅳa(6.2％),and 4 cases were in stage Ⅳb(5.0％).Thirty-nine cases(48.7％)had no lymph node metastasis,41 cases(51.3％)had pelvic lymph node metastasis,8 cases(10.0％)had retroperitoneal lymph node metastasis,and 2 cases(2.5％)had inguinal and left supraclavicular lymph node metastasis.There were 50 cases(62.5％)with nodular tumor morphology,28 cases(35.0％)with cauliflower-like tumor morphology,and 2 cases(2.5％)with cavitary tumor morphology.There were 13 cases(16.3％)of patients with a maximum tumor diameter of ≤4 cm,and 67 cases(83.7％)with a maximum tumor diameter greater than 4 cm.Fifty-two cases(65.0％)underwent pathogen examination of cervical or vaginal secretions.There were 18 cases(34.6％)with negative pathogen detection and 34 cases(65.4％)with positive pathogen detection.The top three common bacteria in pathogenology were Escherichia coli in 18 cases(53.0％),Enterococcus faecalis in 11 cases(32.4％),and Klebsiella pneumoniae in 6 cases(17.7％).Among patients with positive pathogenology,simple infection accounted for 61.8％(21/34)and mixed infection accounted for 38.2％(13/34).Laboratory examination results of C-reactive protein(CRP)and procalcitonin(PCT)were available in 35 patients.The median CRP was 30(3.7,174.0)mg/ml,and the median PCT was 0.05(0.02,0.66)ng/ml.The 3-year survival rate of 80 patients was 75.0％,and the 5-year survival rate was 43.8％.The 3-year progression-free survival rate was 68.8％,and the 5-year progression-free survival rate was 42.5％.In the univariate COX regression model,staging,anemia status,tumor morphology,lymph node metastasis status,pretreatment SCC and maximum tumor diameter were all significant influencing factors for patient survival.Incorporating the significant variables in the univariate model into the multivariate Cox regression model,it was found that staging,tumor morphology,pretreatment SCC,and maximum tumor diameter were independent risk factors for OS.Conclusion The common pathogenic microorganisms of cervical cancer complicated with reproductive tract infection are Gram-negative bacteria,among which Escherichia coli and Klebsiella pneumoniae are more common.The CRP of infected patients is significantly increased,and PCT is normal or only slightly increased.The prognosis of patients with cervical cancer complicated with infection is relatively poor.Later stage,nodular tumor morphology,higher pretreatment SCC and maximum tumor diameter＞4 cm are risk factors for the prognosis of radiotherapy and chemotherapy in patients with cervical cancer complicated with reproductive tract infection.
万方数据
维普
