Objective To compare the treatment outcomes between squamous cell carcinoma ( SCC) and adenocarcino-ma ( ACA) in locally advanced cervical cancer patients. Method All medical records of stagesⅡB~ⅣA of cervical cancer patients who had completed treatment were reviewed. ACA 1 case was matched for SCC 2 cases with clinical stage, tumor size, treatment modalities [ radiation therapy ( RT) vs concurrent chemoradiation ( CCRT) ] . Treatment outcomes including response to RT/CCRT, time to complete response ( CR) , patterns of treatment failure and survival outcomes were analyzed. Result A total of 231 patients with stagesⅡB~ⅣA (77 ACA:154 SCC) were included. Most of the patients ( about 61%) had stageⅡB. The overall complete responses ( CR) between ACA and SCC were 79. 2%and 92. 9%, respectively (P=0. 003<0. 05). Median time to clinical CR from RT/CCRT of ACA were 2 months (0~5 months) compared with 1 month (0~4 months) for SCC (P=0. 001<0. 05). Pelvic recurrence and distant failure were found in 2. 6% and 15. 6% in ACA, and corresponding with 3. 9% and 14. 3% in SCC. The 5-year overall survival rates of ACA compared to SCC were 59. 9% and 61. 7% , respectively. When all prognostic fac-tors are adjusted, clinical staging was the only factor that influenced overall survival. Conclusion ACA in locally ad-vanced cervical cancer had poorer response rate from treatment and also used longer time to achieve CR than SCC. However, these effects were not determinants of survival outcomes.%目的：比较局部浸润宫颈鳞状细胞癌与腺癌的治疗效果。方法查阅本院231例ⅡB~ⅣA期宫颈癌患者(77例宫颈腺癌,154例鳞状细胞癌)的就诊记录,通过临床分期、肿瘤大小和治疗方式(放射治疗或同步放化疗)3个内容对宫颈腺癌和宫颈鳞状细胞癌进行匹配分析。结果宫颈腺癌和宫颈鳞状细胞癌患者治疗后,总完全有效率分别为79.2%和92.9%(P=0.003<0.05),达临床完全有效的平均时间为2个月(0~5个月)和1个月(0~4个月)(P=0.001<0.05),5年总生存率为59.9%和61.7%。宫颈腺癌患者盆腔和转移复发率是2.6%和15.6%,而宫颈鳞状细胞癌患者原位和转移复发率是3.9%和14.3%。校正所有的预后因素可知,临床分期是影响总生存率的惟一因素。结论在局部浸润宫颈癌中,宫颈腺癌的治疗完全有效率较宫颈鳞状细胞癌差,需要更长的时间才能达到完全有效。然而,这些影响并非是生存结果的决定因素。
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