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目的:调查了解某妇产医院年轻妇女宫颈癌发生情况及特点。方法:对2005年1月-2010年12月某妇产医院收治的年龄≤35岁年轻宫颈癌138例,分析其一般状况、临床表现、组织学类型、临床分期、分化程度、大体类型和治疗方法等,并与同期≥36岁宫颈癌149例的临床资料进行比较。结果:≤35岁组宫颈糜烂史、同房出血发生率显著高于≥36岁组(P<0.05);不规则阴道出血发生率显著低于≥36岁组(P<0.05)。月经初潮、初次性生活年龄、孕次、产次、阴道出血时间和接触出血时间两组比较,差异显著(P<0.05)。两组病理类型均以鳞癌为主,≤35岁组鳞癌发病率显著低于≥36岁组,但腺癌和其他癌,如透明细胞癌、小细胞癌发病率显著高于≥36岁组(P<0.05);≤35岁组癌症分期以Ⅰ期为主,≥36岁组以Ⅱ期为主;≤35岁组宫颈癌Ⅰ-Ⅱa期、G2-G3发病率显著高于≥36岁组(P<0.05);≤35岁组宫颈癌大体类型以外生型、糜烂型和脉管癌栓发病率显著高于≥36岁组(P<0.05),而内生型、溃疡空洞型发生率显著低于≥36岁组(P<0.05);≤35岁组以手术治疗为主,≥36岁组以单纯放疗居多。结论:年轻宫颈癌患者多有宫颈糜烂史,临床多表现为接触性出血;组织学类型多为鳞癌;临床分期以Ⅰ期为主,分化程度低;大体类型以外生型和糜烂型多见;治疗以手术为主。
Objective: To investigate the incidence and characteristics of cervical cancer among young women in a maternity hospital. Methods: A total of 138 cases of young cervical cancer aged 35 years and younger admitted to a maternity hospital from January 2005 to December 2010 were analyzed. The general status, clinical manifestations, histological type, clinical stage, degree of differentiation, general type and treatment Methods, etc., and with the same period ≥ 36-year-old cervical cancer clinical data of 149 cases were compared. Results: The incidence of cervical erosion and intercourse hemorrhage was significantly higher than 35 years old (P <0.05). The incidence of irregular vaginal bleeding was significantly lower than that of ≥36 years old (P <0.05). There were significant differences between the two groups in menarche, initial sexual life, gestational age, delivery time, vaginal bleeding time and exposure to bleeding time (P <0.05). Squamous cell carcinoma was the main pathological type in both groups. The incidence of squamous cell carcinoma was significantly lower in patients ≤35 years old than in ≥36 years old group, but the incidence of adenocarcinoma and other cancers such as clear cell carcinoma and small cell carcinoma was significantly higher than that of ≥36 years (P <0.05). Stage Ⅰ was the main cancer stage in patients ≤35 years, stage Ⅱ was predominant in patients ≥36 years old, and incidence of stage Ⅰ-Ⅱa and G2-G3 was significantly higher than ≤36 in ≤35 years (P <0.05). The incidence of ectopic endometrial, erosive and vascular tumor thrombus outside the general type of cervical cancer ≤35 years old was significantly higher than that of ≥36 years old (P <0.05), while the endogenous and ulcer cavity type The incidence was significantly lower than the group of ≥36 years old (P <0.05). The patients under 35 years old were mainly treated by surgery while the group of ≥36 years old was mostly treated by radiotherapy alone. Conclusions: The majority of young patients with cervical cancer have history of cervical erosion, clinical manifestations of contact bleeding; histological types are mostly squamous cell carcinoma; stage Ⅰ clinical stage, the degree of differentiation is low; general types of ectopic and erosive type more common Treatment is mainly surgery.