Journal of International Reproductive Health/Family Planning ›› 2025, Vol. 44 ›› Issue (4): 265-271.doi: 10.12280/gjszjk.20250046
ZHAO Xing-yu, WANG Zhi, FANG Tian, ZHANG Qing-hua()
Received:
2025-01-24
Published:
2025-07-15
Online:
2025-07-28
Contact:
ZHANG Qing-hua, E-mail: ZHAO Xing-yu, WANG Zhi, FANG Tian, ZHANG Qing-hua. Analysis of Clinical Characteristics and Prognosis of Cervical Mucinous Adenocarcinoma: A Cohort Analysis Based on the SEER Database[J]. Journal of International Reproductive Health/Family Planning, 2025, 44(4): 265-271.
Add to citation manager EndNote|Ris|BibTeX
临床特征 | 黏液腺癌 (917例) | 普通型腺癌 (8 487例) | χ2 | P |
---|---|---|---|---|
确诊年龄(岁) | 19.127 | 0.004 | ||
20~24 | 5(0.5) | 43(0.5) | ||
25~34 | 109(11.9) | 1 313(15.5) | ||
35~44 | 256(27.9) | 2 650(31.2) | ||
45~54 | 250(27.3) | 2 047(24.1) | ||
55~64 | 151(16.5) | 1 304(15.4) | ||
65~84 | 137(14.9) | 1 035(12.2) | ||
≥85 | 9(1.0) | 95(1.1) | ||
种族 | 16.483 | 0.002 | ||
白种人 | 721(78.6) | 6 842(80.6) | ||
黑种人 | 59(6.4) | 613(7.2) | ||
亚洲人/太平洋岛民 | 130(14.2) | 887(10.5) | ||
美洲印第安人/ 阿拉斯加土著 | 4(0.4) | 67(0.8) | ||
未知 | 3(0.3) | 78(0.9) | ||
FIGO 2018分期 | 89.445 | <0.001 | ||
Ⅰ期 | 374(40.8) | 4 559(53.7) | ||
Ⅱ期 | 194(21.2) | 1 855(21.9) | ||
Ⅲ期 | 176(19.2) | 1 135(13.4) | ||
Ⅳ期 | 173(18.9) | 938(11.1) | ||
NCCN分期 | 76.265 | <0.001 | ||
早期 | 329(35.9) | 3 933(46.3) | ||
局部晚期 | 386(42.1) | 3 117(36.7) | ||
转移期 | 158(17.2) | 832(9.8) | ||
未知 | 44(4.8) | 605(7.1) | ||
肿瘤直径(cm) | 73.067 | <0.001 | ||
≤2 | 206(22.5) | 1 789(21.1) | ||
2~4 | 159(17.3) | 1 024(12.1) | ||
>4 | 186(20.3) | 1 156(13.6) | ||
未知 | 366(39.9) | 4 518(53.2) | ||
淋巴结转移 | 37.413 | <0.001 | ||
否 | 667(72.7) | 6 857(80.8) | ||
是 | 205(22.4) | 1 258(14.8) | ||
未知 | 45(4.9) | 372(4.4) | ||
手术 | 7.752 | 0.005 | ||
否 | 211(23.0) | 2 317(27.3) | ||
是 | 706(77.0) | 6 170(72.7) | ||
放疗 | 68.569 | <0.001 | ||
否/未知 | 417(45.5) | 5 064(59.7) | ||
是 | 500(54.5) | 3 423(40.3) | ||
化疗 | 83.674 | <0.001 | ||
否/未知 | 464(50.6) | 5 587(65.8) | ||
是 | 453(49.4) | 2 900(34.2) |
临床特征 | 黏液腺癌 (917例) | 普通型腺癌 (8 487例) | χ2 | P |
---|---|---|---|---|
确诊年龄(岁) | 19.127 | 0.004 | ||
20~24 | 5(0.5) | 43(0.5) | ||
25~34 | 109(11.9) | 1 313(15.5) | ||
35~44 | 256(27.9) | 2 650(31.2) | ||
45~54 | 250(27.3) | 2 047(24.1) | ||
55~64 | 151(16.5) | 1 304(15.4) | ||
65~84 | 137(14.9) | 1 035(12.2) | ||
≥85 | 9(1.0) | 95(1.1) | ||
种族 | 16.483 | 0.002 | ||
白种人 | 721(78.6) | 6 842(80.6) | ||
黑种人 | 59(6.4) | 613(7.2) | ||
亚洲人/太平洋岛民 | 130(14.2) | 887(10.5) | ||
美洲印第安人/ 阿拉斯加土著 | 4(0.4) | 67(0.8) | ||
未知 | 3(0.3) | 78(0.9) | ||
FIGO 2018分期 | 89.445 | <0.001 | ||
Ⅰ期 | 374(40.8) | 4 559(53.7) | ||
Ⅱ期 | 194(21.2) | 1 855(21.9) | ||
Ⅲ期 | 176(19.2) | 1 135(13.4) | ||
Ⅳ期 | 173(18.9) | 938(11.1) | ||
NCCN分期 | 76.265 | <0.001 | ||
早期 | 329(35.9) | 3 933(46.3) | ||
局部晚期 | 386(42.1) | 3 117(36.7) | ||
转移期 | 158(17.2) | 832(9.8) | ||
未知 | 44(4.8) | 605(7.1) | ||
肿瘤直径(cm) | 73.067 | <0.001 | ||
≤2 | 206(22.5) | 1 789(21.1) | ||
2~4 | 159(17.3) | 1 024(12.1) | ||
>4 | 186(20.3) | 1 156(13.6) | ||
未知 | 366(39.9) | 4 518(53.2) | ||
淋巴结转移 | 37.413 | <0.001 | ||
否 | 667(72.7) | 6 857(80.8) | ||
是 | 205(22.4) | 1 258(14.8) | ||
未知 | 45(4.9) | 372(4.4) | ||
手术 | 7.752 | 0.005 | ||
否 | 211(23.0) | 2 317(27.3) | ||
是 | 706(77.0) | 6 170(72.7) | ||
放疗 | 68.569 | <0.001 | ||
否/未知 | 417(45.5) | 5 064(59.7) | ||
是 | 500(54.5) | 3 423(40.3) | ||
化疗 | 83.674 | <0.001 | ||
否/未知 | 464(50.6) | 5 587(65.8) | ||
是 | 453(49.4) | 2 900(34.2) |
分期 | 手术 | 放疗 | 化疗 | |||
---|---|---|---|---|---|---|
黏液腺癌 (706例) | 普通型腺癌 (6 170例) | 黏液腺癌 (500例) | 普通型腺癌 (3 423例) | 黏液腺癌 (453例) | 普通型腺癌 (2 900例) | |
FIGO 2018分期 | ||||||
Ⅰ | 353(50.0) | 4 160(67.4) | 109(21.8) | 931(27.2) | 71(15.7) | 602(20.8) |
Ⅱ | 133(18.8) | 1 268(20.6) | 123(24.6) | 965(28.2) | 98(21.6) | 752(25.9) |
Ⅲ | 122(17.3) | 502(8.1) | 159(31.8) | 996(29.1) | 152(33.6) | 906(31.2) |
Ⅳ | 98(13.9) | 240(3.9) | 109(21.8) | 531(15.5) | 132(29.1) | 640(22.1) |
χ2 | 217.235 | 18.479 | 17.073 | |||
P | <0.001 | <0.001 | <0.001 | |||
NCCN分期a | ||||||
早期 | 316(47.2) | 3 661(64.4) | 96(19.7) | 777(23.6) | 61(13.7) | 495(16.6) |
局部晚期 | 263(39.3) | 1 809(31.8) | 295(60.5) | 2 054(62.5) | 263(59.2) | 1 744(62.9) |
转移期 | 91(13.6) | 213(3.7) | 97(19.9) | 456(13.9) | 120(27.1) | 569(20.5) |
χ2 | 159.760 | 13.631 | 12.183 | |||
P | <0.001 | 0.001 | 0.002 |
分期 | 手术 | 放疗 | 化疗 | |||
---|---|---|---|---|---|---|
黏液腺癌 (706例) | 普通型腺癌 (6 170例) | 黏液腺癌 (500例) | 普通型腺癌 (3 423例) | 黏液腺癌 (453例) | 普通型腺癌 (2 900例) | |
FIGO 2018分期 | ||||||
Ⅰ | 353(50.0) | 4 160(67.4) | 109(21.8) | 931(27.2) | 71(15.7) | 602(20.8) |
Ⅱ | 133(18.8) | 1 268(20.6) | 123(24.6) | 965(28.2) | 98(21.6) | 752(25.9) |
Ⅲ | 122(17.3) | 502(8.1) | 159(31.8) | 996(29.1) | 152(33.6) | 906(31.2) |
Ⅳ | 98(13.9) | 240(3.9) | 109(21.8) | 531(15.5) | 132(29.1) | 640(22.1) |
χ2 | 217.235 | 18.479 | 17.073 | |||
P | <0.001 | <0.001 | <0.001 | |||
NCCN分期a | ||||||
早期 | 316(47.2) | 3 661(64.4) | 96(19.7) | 777(23.6) | 61(13.7) | 495(16.6) |
局部晚期 | 263(39.3) | 1 809(31.8) | 295(60.5) | 2 054(62.5) | 263(59.2) | 1 744(62.9) |
转移期 | 91(13.6) | 213(3.7) | 97(19.9) | 456(13.9) | 120(27.1) | 569(20.5) |
χ2 | 159.760 | 13.631 | 12.183 | |||
P | <0.001 | 0.001 | 0.002 |
项目 | 单因素Cox回归 | 多因素Cox回归 | ||
---|---|---|---|---|
HR(95%CI) | P | HR(95%CI) | P | |
确诊年龄(岁) | ||||
≤44 | 参照 | 参照 | ||
45~64 | 2.083(1.638~2.653) | <0.001 | 1.467(1.134~1.898) | 0.004 |
≥65 | 5.369(4.081~7.062) | <0.001 | 3.224(2.358~4.407) | <0.001 |
种族 | ||||
白种人 | 参照 | 参照 | ||
亚洲人/太平洋岛民 | 1.367(1.035~1.806) | 0.028 | 1.526(1.137~2.048) | 0.005 |
黑种人 | 1.815(1.278~2.579) | <0.001 | 1.083(0.733~1.600) | 0.688 |
FIGO分期 | ||||
Ⅰ | 参照 | 参照 | ||
Ⅱ | 4.159(2.955~5.854) | <0.001 | 2.507(1.740~3.613) | <0.001 |
Ⅲ | 6.363(4.535~8.927) | <0.001 | 3.648(2.320~5.735) | <0.001 |
Ⅳ | 14.819(10.652~20.618) | <0.001 | 10.120(6.717~15.251) | <0.001 |
肿瘤直径(cm) | ||||
≤2 | 参照 | 参照 | ||
2~4 | 2.251(1.523~3.328) | <0.001 | 1.793(1.186~2.709) | 0.005 |
>4 | 4.475(3.132~6.394) | <0.001 | 1.825(1.219~2.733) | 0.003 |
淋巴结转移 | ||||
否 | 参照 | 参照 | ||
是 | 2.965(2.384~3.689) | <0.001 | 1.349(0.995~1.829) | 0.050 |
手术 | ||||
否 | 参照 | 参照 | ||
是 | 0.218(0.177~0.268) | <0.001 | 0.440(0.340~0.569) | <0.001 |
放疗 | ||||
否/未知 | 参照 | 参照 | ||
是 | 2.583(2.071~3.221) | <0.001 | 1.370(1.024~1.843) | 0.034 |
化疗 | ||||
否/未知 | 参照 | 参照 | ||
是 | 2.787(2.253~3.448) | <0.001 | 0.659(0.484~0.898) | 0.008 |
项目 | 单因素Cox回归 | 多因素Cox回归 | ||
---|---|---|---|---|
HR(95%CI) | P | HR(95%CI) | P | |
确诊年龄(岁) | ||||
≤44 | 参照 | 参照 | ||
45~64 | 2.083(1.638~2.653) | <0.001 | 1.467(1.134~1.898) | 0.004 |
≥65 | 5.369(4.081~7.062) | <0.001 | 3.224(2.358~4.407) | <0.001 |
种族 | ||||
白种人 | 参照 | 参照 | ||
亚洲人/太平洋岛民 | 1.367(1.035~1.806) | 0.028 | 1.526(1.137~2.048) | 0.005 |
黑种人 | 1.815(1.278~2.579) | <0.001 | 1.083(0.733~1.600) | 0.688 |
FIGO分期 | ||||
Ⅰ | 参照 | 参照 | ||
Ⅱ | 4.159(2.955~5.854) | <0.001 | 2.507(1.740~3.613) | <0.001 |
Ⅲ | 6.363(4.535~8.927) | <0.001 | 3.648(2.320~5.735) | <0.001 |
Ⅳ | 14.819(10.652~20.618) | <0.001 | 10.120(6.717~15.251) | <0.001 |
肿瘤直径(cm) | ||||
≤2 | 参照 | 参照 | ||
2~4 | 2.251(1.523~3.328) | <0.001 | 1.793(1.186~2.709) | 0.005 |
>4 | 4.475(3.132~6.394) | <0.001 | 1.825(1.219~2.733) | 0.003 |
淋巴结转移 | ||||
否 | 参照 | 参照 | ||
是 | 2.965(2.384~3.689) | <0.001 | 1.349(0.995~1.829) | 0.050 |
手术 | ||||
否 | 参照 | 参照 | ||
是 | 0.218(0.177~0.268) | <0.001 | 0.440(0.340~0.569) | <0.001 |
放疗 | ||||
否/未知 | 参照 | 参照 | ||
是 | 2.583(2.071~3.221) | <0.001 | 1.370(1.024~1.843) | 0.034 |
化疗 | ||||
否/未知 | 参照 | 参照 | ||
是 | 2.787(2.253~3.448) | <0.001 | 0.659(0.484~0.898) | 0.008 |
[1] | Adegoke O, Kulasingam S, Virnig B. Cervical cancer trends in the United States: a 35-year population-based analysis[J]. J Womens Health(Larchmt), 2012, 21(10):1031-1037. doi: 10.1089/jwh.2011.3385. |
[2] |
Ward KK, Shah NR, Saenz CC, et al. Changing demographics of cervical cancer in the United States (1973-2008)[J]. Gynecol Oncol, 2012, 126(3):330-333. doi: 10.1016/j.ygyno.2012.05.035.
pmid: 22668881 |
[3] | 朱梅娟, 陈婕, 刘瑞旭. 子宫颈黏液腺癌35例临床病理分析[J]. 上海交通大学学报(医学版), 2014, 34(1):79-82. doi: 10.3969/j.issn.1674-8115.2014.01.017. |
[4] | 贾艳艳, 宋小幸, 张明会. 45例宫颈黏液腺癌临床病理分析[J]. 现代妇产科进展, 2024, 33(3):208-212. doi: 10.13283/j.cnki.xdfckjz.2024.03.011. |
[5] | Bonin L, Devouassoux-Shisheboran M, Golfier F. Clinicopathological characteristics of patients with mucinous adenocarcinoma of the uterine cervix: A retrospective study of 21 cases[J]. J Gynecol Obstet Hum Reprod, 2019, 48(5):319-327. doi: 10.1016/j.jogoh.2019.02.002. |
[6] |
Stolnicu S, Barsan I, Hoang L, et al. International Endocervical Adenocarcinoma Criteria and Classification (IECC): A New Pathogenetic Classification for Invasive Adenocarcinomas of the Endocervix[J]. Am J Surg Pathol, 2018, 42(2):214-226. doi: 10.1097/PAS.0000000000000986.
pmid: 29135516 |
[7] |
Andersson S, Rylander E, Larsson B, et al. The role of human papillomavirus in cervical adenocarcinoma carcinogenesis[J]. Eur J Cancer, 2001, 37(2):246-250. doi: 10.1016/s0959-8049(00)00376-2.
pmid: 11166153 |
[8] |
Quint KD, de Koning MN, Geraets DT, et al. Comprehensive analysis of Human Papillomavirus and Chlamydia trachomatis in in-situ and invasive cervical adenocarcinoma[J]. Gynecol Oncol, 2009, 114(3):390-394. doi: 10.1016/j.ygyno.2009.05.013.
pmid: 19500822 |
[9] | Abu-Rustum NR, Yashar CM, Arend R, et al. NCCN Guidelines® Insights: Cervical Cancer, Version 1.2024[J]. J Natl Compr Canc Netw, 2023, 21(12):1224-1233. doi: 10.6004/jnccn.2023.0062. |
[10] | 宋小幸. 95例宫颈黏液腺癌患者的临床病理特征及预后分析[D]. 郑州: 郑州大学, 2024. |
[11] | Hao Y, Liu Q, Li R, et al. Analysis of prognostic factors for cervical mucinous adenocarcinoma and establishment and validation a nomogram: a SEER-based study[J]. J Obstet Gynaecol, 2023, 43(1):2153027. doi: 10.1080/01443615.2022.2153027. |
[12] |
Landoni F, Maneo A, Colombo A, et al. Randomised study of radical surgery versus radiotherapy for stage Ⅰb-Ⅱa cervical cancer[J]. Lancet, 1997, 350(9077):535-540. doi: 10.1016/S0140-6736(97)02250-2.
pmid: 9284774 |
[13] |
Mayadev JS, Ke G, Mahantshetty U, et al. Global challenges of radiotherapy for the treatment of locally advanced cervical cancer[J]. Int J Gynecol Cancer, 2022, 32(3):436-445. doi: 10.1136/ijgc-2021-003001.
pmid: 35256434 |
[1] | SONG Meng-meng, CHEN Fang, BAO Xiang-xiang, TIAN Xin-li. Research Progress of PRMT5 in Gynecological Malignant Tumors [J]. Journal of International Reproductive Health/Family Planning, 2025, 44(2): 171-176. |
[2] | LIU Si-min, WANG Jia-li, ZHANG Shi-xia, WEI Jia, YANG Yong-xiu. Dermatofibrosarcoma Protuberans of Vulva: A Case Report [J]. Journal of International Reproductive Health/Family Planning, 2024, 43(6): 490-493. |
[3] | XU Qian, CHENG Jiu-mei. Clinical Analysis of 17 Cases of Cervical Lipoleiomyoma [J]. Journal of International Reproductive Health/Family Planning, 2024, 43(5): 390-394. |
[4] | WANG Jing, WANG Xiao-hui. Small Cell Neuroendocrine Carcinoma of the Endometrium: A Case Report and Literature Review [J]. Journal of International Reproductive Health/Family Planning, 2024, 43(3): 212-215. |
[5] | CHU Man-wei, CHEN Huan-huan, WANG Qian, WANG Yi-wen, LI Dan, YANG Shu-jun, ZHANG Cui-lian. The Mechanism of MiR-20a in Common Gynecological Malignant Tumors [J]. Journal of International Reproductive Health/Family Planning, 2024, 43(2): 172-176. |
[6] | GAO Ya-ting, WANG Fang, MA Jian-hong, MA Yi-tong, LIU Chang. Research Progress of Cuproptosis in Gynecologic Malignant Tumor [J]. Journal of International Reproductive Health/Family Planning, 2024, 43(1): 74-78. |
[7] | FENG Ya-ru, LI Xue, ZHANG Hui-ying. Fatty Acid Synthase and Its Inhibitors in Endometrial Cancer [J]. Journal of International Reproductive Health/Family Planning, 2024, 43(1): 79-82. |
[8] | ZHANG Ting-ting, WANG Li, YU Ping-yuan, CHEN Xi, YANG Yong-xiu. Small Cell Neuroendocrine Carcinoma of the Cervix: A Case Report and Literature Review [J]. Journal of International Reproductive Health/Family Planning, 2023, 42(6): 462-466. |
[9] | ZHANG Zhe, ZHANG Wei. Menopausal Hormone Therapy and the Risk of Gynecological Malignancy [J]. Journal of International Reproductive Health/Family Planning, 2023, 42(6): 519-523. |
[10] | AN Rong, WANG Xiao-hui. Ovarian Primitive Neuroectodermal Tumor: A Case Report and Literature Review [J]. Journal of International Reproductive Health/Family Planning, 2023, 42(5): 376-379. |
[11] | WANG Min, AN Rong, ZHANG Jing, QI Qi, XU Fei-xue. Synchronous Cervical Adenocarcinoma Combined with Ovarian Cancer: A Case Report and Literature Review [J]. Journal of International Reproductive Health/Family Planning, 2023, 42(5): 387-391. |
[12] | GAO Ya-ting, MA Jian-hong, MA Yi-tong, LIU Chang. Progress on the Relationship between Ferroptosis and Cervical Cancer [J]. Journal of International Reproductive Health/Family Planning, 2023, 42(5): 436-440. |
[13] | GE Yam, XU Fei-xue, Ll Hong-wei, GAO Ming-xia. Analysis of BRCA1/2 Gene Mutation in 51 Patients with Ovarian Cancer [J]. Journal of International Reproductive Health/Family Planning, 2023, 42(4): 277-281. |
[14] | XIANG Qing-yi, TANG Hai-yang, PAN Yu-xia, BAI Xiao-xia. Progress in Diagnosis and Treatment of Cystic Meconium Peritonitis [J]. Journal of International Reproductive Health/Family Planning, 2023, 42(4): 343-347. |
[15] | CHEN Xi, YANG Yong-xiu. Clinical Characteristics and Treatment of Microsatellite Instability Type of Endometrial Cancer [J]. Journal of International Reproductive Health/Family Planning, 2023, 42(1): 77-82. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||