ABSTRACT
Objective@#To explore the poor prognostic factors of patients with cervical stump carcinoma, aiming to provide certain reference for the clinical diagnosis and treatment.@*Methods@#Clinical data of 48 patients with cervical stump carcinoma admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from January 1, 2005 to December 1, 2016 were retrospectively analyzed. A total of 19 patients (40%) withⅠA-ⅡA stage cervical stump carcinoma were treated with surgery+ adjuvant therapy and 29 patients (60%) in ⅡB-Ⅳ stage received radiotherapy combined with chemotherapy. The median age of onset was 51 years old. Uterine fibroids were the main cause of subtotal hysterectomy. The average time interval from subtotal hysterectomy to definite diagnosis was 10.76 years.@*Results@#The 1-, 3-, 5-year survival rate was 98%, 83% and 74%, respectively. Univariate analysis demonstrated the time interval from subtotal hysterectomy (P=0.016), tumor diameter (P=0.016), clinical stage (P=0.036), histological grade (P=0.009), lymph node metastasis (P=0.044), parametrial invasion (P=0.046), myelosuppression (P=0.013) and radical surgery (P=0.019) were the poor prognostic factors of cervical stump carcinoma.@*Conclusions@#Poor prognosis of patients with cervical stump carcinoma is correlated with tumor diameter, clinical stage, histological grade, lymph node metastasis, parametrial invasion and myelosuppression. Histological grade is an independent risk factor.
ABSTRACT
Objective To evaluate the feasibility and therapeutic efficacy of prophylactic implantation of intraaortic balloon pump in patients with high-risk coronary artery disease.Methods 121 patients with high-risk coronary heart disease who received prophylactic implantation of intraaortic balloon pump in percutaneous coronary intervention were enrolled as the treatment group (Group A),and another 119 patients with high-risk coronary heart disease who had conventional coronary intervention were enrolled as the control group (Group B).The rates of intraoperative malignant arrhythmia (ventricular tachycardia,ventricular fibrillation),acute left heart failure,cardiogenic shock and sudden death were compared between the two group.NT-proBNP levels,left ventricular systolic function and the rates of major adverse cardiac events,within 30 days of PCI and after 1 year were compared between the two groups.Results The event rates of intraoperative malignant arrhythmia,acute left heart failure,cardiogenic shock,and sudden death in Group A was significantly lower than those in Group B (all P ＜ 0.05).Postoperative hematoma were found in 2 cases,aortic dissection in 1 case and thrombocytopenia in 1 case in Group A without significant difference as compared to Group B (P ＞ 0.05).Within 30 days after PCI,NT-proBNP levels and left ventricular diastolic diameter in Group A were lower than those in Group B while the left ventricular ejection fraction in Group A was higher than that in Group B (all P ＜ 0.05).The rates of major cardiac adverse events,including sudden cardiac death and severe heart failure were lower than those in Group B (all P ＜ 0.05).At 1 year after PCI,the NT-proBNP levels left ventricular diastolic diameter in Group A were lower than those in Group B with the left ventricular ejection fraction in Group A was higher than that in Group B (all P ＜ 0.05).There were no significant differences in the rates of major cardiac adverse events,including sudden cardiac death and severe heart failure after 1 year(all P ＞ 0.05).Conclusions For patients with high-risk coronary heart disease undergoing coronary intervention,prophylactic implantation of intraaortic balloon pump may decrease the incidence of intraoperative complications,reduce the incidence of cardiac death and severe heart failure within 30 days,and improve the left ventricular function after 1 year.Its role in reducing long term major cardiac adverse events after 1 year still needs more clinical trials for funther justification.