| Cervical cancer is one of the most common cancers for women. The present study attempts to explore the mini-invasive surgery and prognositic factors of cervical cancer and conduct the database to administrate the data of cervical cancer. This article includes three parts. The first part is the primary comparative research of mini-invasive surgery for cervical cancer. The second part is to design and conduct the database of cervical cancer. The third part is to conduct a mathmatics model to predict survival rate for cervical cancer.Part 1 Primary comparative research of mini-invasive surgery of cervical cancerOBJECTIVE:The aim of this study was to objectively evaluate the benefits of laparoscopic radical hysterectomy(LRH)compare to abdominal radical hysterectomy (ARH) and vaginal hysterectomy for early-stage cervical cancer. STUDY DESIGN:487 clinical data of patients with IA-IIB cervical cancer who underwent LRH and ARH and vaginal hysterectomy were collected.63 of it (laparascopic group, n1=33 and abdominal group, n2=30) were prospectively collected peripheral blood samples in perioperation to measure serum interleukin-6 (IL-6), heat shock protein (HSP-70), C-reactive protein(CRP), tumor necrosis factor-α(TNF-α) and Cortisol. RESULTS:There was no signifinant different in age, Quetelet index, histology, grade, resected pelvic lymph nodes in three groups. In 63 cases, the average blood loss was 317.23±217.20 mL (laparoscopic) to 872.58±693.16mL (laparotomy) and it is significant different. At 1 and 7 day after surgery, the serum IL-6 is significant lower in the laparascopic group compare to the lapatomy group [(day 1:laparoscopic (17.14 ±16.53pg/mL) and open(34.32±20.97pg/mL), P=0.001; day 7:laparoscopic (6.7±7.21pg/mL) and open (17.54±16.47pg/mL), P=0.001]. The serum concentration of CRP is significant increase both in two groups after operation, at 1 and 7 day it is significant lower in the laparoscopic compare to the other group (day 1:laparoscopic (7024.72±949.12 ng/mL) and open(7586.61±869.42 ng/mL) P=0.018); day 7: laparoscopic (4357.71±2108.85 ng/mL) and open (6967.96±995.02 ng/mL) P<0.001)]. There is significant different at 4 day after operation about the concentration of serum Cortisol (122.29±65.17 ng/ml, laparoscopic and 186.76±68.61 ng/ml, laparotomy, p<0.001]. CONCLUSION:Changes in the clinical data and various parameters pertinent to surgical stress evaluated in this study suggested that laparoscopic surgery for cervical cancer lead to less postoperative stress than conventional open surgery and recovery earlier.Part 2 Design and construct of database application system for cervical cancerObjective:To design and construct database application system for cervical cancer. Methods:Blueprint of the data structure was designed and accomplished based on the resolution of data flow of cervical cancer after requirements. Performance test and analysis was carried out for clinical application. Results:The database and the application including user defined quering utilities were finished and applied to clinic usage. Conclusions:The application system, which can provide support for clinical real-time decision, will increase the efficiency of data management of cervical cnacer and analysis. It can helpful for clinical dactors and researchers.Part 3 Conduction of mathmatics model to predict the survival rate for cervical cancerObjective:To construct a mathmatics model to predict the survival rate for cervical cancer. Methods:To review the clinical data of 693 patients with cervical cancer who underwent operation at our hospital between 2005 and 2011. A univariate analysis and multivariate Cox regression model was used to identify the prognostic weight of clinical and histological factors for cervical cancer. Result:Univariate analysis showed that six progonostic factors were associated with the survival rate of the patients with cervical cancer. These are:tumor size, depth of invasion, FIGO stage, tumor histological grade, cell differentiation, lymph node metastasis. The multivariate regression suggested that four of those except for tumor size and depth of invasion were associated with the prognosis of cervical cancer. Conclusions:The mathmatics model which can predicte survival rate of cervical cancer has useful value for clinical therapy. |
PDF Full Text Request