Objective To explore the impact of impaired glucose regulation(IGR)on recurrence within 2 years after modified radical surgery in cervical cancer patients.Methods A total of 106 patients with newly diagnosed cervical cancer who were hospitalized in the Second Hospital of Shijiazhuang from March 2019 to February 2021 were selected as the study subjects.All patients were scheduled for modified radical surgery of cervical cancer.By retrospective analysis,the patients were divided into recurrence group(n=20)and non-recurrence group(n=86)according to the tumor recurrence within 2 years after operation.According to the definition of the Guidelines for Prevention and Treatment of Type 2 Diabetes in China(2017 Edition),patients were evaluated and divided into IGR and normal glucose tolerance(NGT).And IGR included impaired fasting glucose(IFG)and impaired glucose tolerance(IGT).Log-rank test was used to compare the risk of recurrence within 2 years after modified radical surgery of cervical cancer between two groups.Cox proportional hazard regression was used to analyze the independent influencing factors of recurrence within 2 years after modified radical hysterectomy in patients with cervical cancer,and a nomogram prediction model for recurrence within 2 years after modified radical surgery of cervical cancer patients was constructed based on these independent influencing factors.This study was approved by the Medical Ethics Committee of the Second Hospital of Shijiazhuang(Approval No.KY2019-012).All patients signed the informed consent forms for clinical research.Results ① Among the 106 patients in this study,33 cases were diagnosed as IFG and 25 cases as IGT.The proportion of patients with IGR was 54.7％.The recurrence time of 20 patients with cervical cancer recurrence was 15.50 months.The risk of recurrence within 2 years after modified radical resection in patients with IGR was higher than that in patients with NGT,and the difference was statistically significant(X2=8.93,P=0.003).② The proportion of patients with International Federation of Gynecology and Obstetrics(FIGO)stage Ⅱ A,the rate of lymphatic vascular invasion(LVSI),the incidence of tumor invasion of the cervical stroma of 1/3 deep,the positive rate of parauterine tissue infiltration,the proportion of patients with IGR,and the serum levels of squamous cell carcinoma antigen(SCC)and cytokeratin 19 fragment(CYFRA21-1)in recurrence group were higher than those in non-recurrence group,and the differences were statistically significant(P＜0.05).③ Cox proportional hazard regression analysis showed that patients with IGR(HR=4.342,95％CI:1.192-15.820,P=0.026),FIGO stage Ⅱ A(HR=3.794,95％CI:1.316-10.935,P=0.014),LVSI(HR=3.017,95％CI:1.137-8.007,P=0.027),serum SCC level increased(HR=1.250,95％CI:1.015-1.538,P=0.036),serum CYFRA21-1 level increased(HR=1.217,95％CI:1.042-1.420,P=0.013)were all independent risk factors for recurrence within 2 years after modified radical hysterectomy in patients with cervical cancer.④ The C-index of the nomogram prediction model of recurrence risk within 2 years after modified radical resection of cervical cancer was 0.874.The calibration curve showed that the prediction results of the nomogram were consistent with the observation results.The area under the curve(AUC)of the receiver operating characteristic(ROC)curve of the prediction model was 0.874.Conclusion Cervical cancer patients with IGR have an increased risk of recurrence within 2 years after modified radical surgery.
NETL
NSTL
万方数据
