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目的:探讨贵州省黔南州布依族和水族宫颈癌患者临床病理特征及预后情况。方法:选择宫颈癌患者196例,所有患者均经病理诊断证实。按民族将其分为布依族组100例和水族组96例,分别比较两组患者临床资料、病理分期、宫颈形态、病理分型、组织学分级、临床表现以及预后生存率等方面的差异。结果:①布依族宫颈癌患者宫颈形态以糜烂型为主,临床分期以Ⅱ期为主,病理分型以鳞癌为主,组织学分级分化程度高。宫颈肌层浸润深度大多<1/2肌层,淋巴管累及、盆腔淋巴结转移少;水族宫颈癌患者宫颈形态以溃疡型为主,临床分期以Ⅲ～Ⅳ期为主,病理分型多表现为腺癌和腺鳞癌,组织学分化程度低,宫颈肌层浸润深度大多≥1/2肌层,淋巴管累及、盆腔淋巴结转移病例较多。两组差异有统计学意义(P<0.01);而两组宫颈癌患者肿瘤直径比较,差异无统计学意义(P>0.05)。②布依族宫颈癌患者总预后情况与水族比较,差异有统计学意义(P<0.01),布依族宫颈癌患者5年生存率较水族高,总预后情况优于水族患者。③复发相关因素:临床分期为Ⅲ～Ⅳ期的患者、病理分型为腺癌、宫颈肌层浸润深度全层等因素是影响两民族宫颈癌患者复发的因素。结论:布依族和水族宫颈癌患者具有各自特定的临床病理特点,临床诊疗中应引起高度重视。
Objective: To investigate the clinicopathological features and prognosis of Buyi and Aquarium cervical cancer in Qiannan Prefecture of Guizhou Province. Methods: 196 cases of cervical cancer patients were selected, all patients confirmed by pathological diagnosis. According to ethnic groups, they were divided into Buyi group (100 cases) and Aquarium group (96 cases). The clinical data, pathological staging, cervical morphology, pathological classification, histological grade, clinical manifestations and prognosis survival rate were compared between the two groups. Results: (1) Cervical cancer patients in Bouyei ethnic group were characterized by erosive type. The clinical stage was mainly in stage Ⅱ. The pathological type was mainly squamous cell carcinoma with high grade of histological differentiation. Most of the cervical myometrial invasion depth of <1/2 muscle layer, lymphatic involvement, pelvic lymph node metastasis less; cervical cancer patients with aquaria cervical ulcer-based, clinical stage Ⅲ to Ⅳ mainly staging more Adenocarcinoma and adenosquamous carcinoma, histological differentiation is low, most of the depth of myometrial invasion ≥ 1/2 muscle, lymphatic involvement, more cases of pelvic lymph node metastasis. The differences between the two groups were statistically significant (P <0.01). There was no significant difference in tumor diameter between the two groups (P> 0.05). (2) The total prognosis of patients with cervical cancer in Buyi ethnic group was significantly different from that of the aquariums (P <0.01). The 5-year survival rate of Buyi family of cervical cancer patients was higher than that of the aquariums and the overall prognosis was better than that of the aquariums. ③ relapse related factors: clinical stage Ⅲ ~ Ⅳ patients, pathological type of adenocarcinoma, cervical myometrial invasion depth and other factors affecting the recurrence of cervical cancer two ethnic factors. Conclusion: Buyi and Aquarium cervical cancer patients have their own specific clinical and pathological features, clinical diagnosis and treatment should be given high priority.