年轻妇女宫颈癌的临床特征和预后  

Clinical and prognostic studies on cervical cancer in young women

作　　者：周碧芳[1] 

机构地区：[1]南京医科大学附属肿瘤医院江苏省肿瘤医院妇瘤科,江苏南京210009

出　　处：《南京医科大学学报（自然科学版）》2005年第7期504-506,共3页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:探讨年轻宫颈癌(≤35岁)的发病趋势、临床病理特征及预后,并与中老年宫颈癌(>35岁)进行比较。方法:对126例年轻宫颈癌(研究组)以及随机选择的同期200例中老年宫颈癌(对照组)进行回顾性分析,比较两组临床病理特征和5年生存率。结果:年轻宫颈癌新增病例所占比例呈逐年递增趋势,由1997年的7.8%至2002年的10.9%,研究组以接触性阴道出血为主要症状,占57.1%(72/126),对照组仅18.5%(37/200)(P<0.01),腺癌所占比例研究组为21.4%(27/126),对照组为12%(24/200)(P<0.05);盆腔淋巴结转移率两组分别为31.7%(13/41)、11.3%(7/62)(P<0.05),卵巢转移率为0,Ⅰ、Ⅱ、Ⅲ期5年生存率研究组为75.0%、61.2%、32.7%,对照组为88.1%、81.3%、68.7%,两组对照Ⅰ期无统计学意义而Ⅱ、Ⅲ期差异显著(P<0.05)。结论:年轻宫颈癌发病呈上升趋势,其原因可能与性传播有关,年轻宫颈鳞癌患者手术时保留卵巢是安全可行的,年轻宫颈癌患者预后差与腺癌比例增高,淋巴结转移率高有关。Objective: To study whether the prevalence, clinical characteristic and survival of young cervical cancer patients under 35 years old differed from those of cervical cancer patients over 35 years old. Methods: Retrospective analysis was carried out to compare the clinical features and survival rate of 5 years of 126 young patients (study group) with those of 200 by randomly selected older ones (control group). Results: The percentage of new cervical cancer in study group increased from 7.8% in 1997 to 10.9% in 2002. Contact bleeding was the main symptom that occurred in 57.1% (72/126) in study group but 18.5% (37/200) in control group (P < 0.01) .The rate of adenocarcinoma was 21.4% (27/126), 12% (24/200) respectively (P < 0.05) .The rate of pelvic lymph metastasis was 31.7% (13/41) and 11.3% (7/62). The ovarian metastasis was none. The survival rate of 5 years in study group was 75.0%, 61.2% , 32.7% in stage Ⅰ, stage Ⅱ and stage Ⅲ respectively . In control group it was 88.1% , 81.3% , 68.7% respectively. There was no statistical significance in stage Ⅰ, but it was different in stage Ⅱ and Ⅲ (P < 0.05). Conclusion: There is an increasing prevalence of cervical cancer in young women, which is possibly related to the sexual transition. The preserving ovary in young cervical cancer patients is safe and effective. The poor prognosis of cervical cancer in young women is probably related to the increasing proportion of adenocarcinoma and high involvement of lymph node.

关 键 词：宫颈肿瘤 诊断 预后 

分 类 号：R365[医药卫生—病理学]