年轻妇女宫颈癌临床分析  

Clinical analysis of cervical cancer in young women

作　　者：卢玉兰[1] 刘晓梅[1] 蔡红兵[1] 黄奕[2] 李晓兰 聂道梅 周全[5] 潘凤莲[6] 李志英 王晓燕 戴英[9] 

机构地区：[1]武汉大学中南医院妇瘤科,湖北省肿瘤医学临床研究中心,肿瘤生物行为湖北省重点实验室,武汉430071 [2]湖北省肿瘤医院,武汉430079 [3]湖北省长阳县妇幼保健院,宜昌443500 [4]五峰土家族自治县妇幼保健院,五峰440000 [5]荆州市第一人民医院,荆州434000 [6]荆州市第二人民医院,荆州434000 [7]宜昌仁和医院,宜昌443000 [8]老河口中心医院,老河口441800 [9]黄冈中心医院,黄冈438000

出　　处：《中国肿瘤临床与康复》2011年第2期134-137,共4页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：湖北省卫生厅重点项目(JX3A17);湖北省自然科学基金(2007ABA056)支助

摘　　要：目的了解湖北省近30余年年轻宫颈癌的发病趋势、危险因素、临床表现及组织病理学特征。方法收集湖北省武汉市、宜昌地区、荆州地区、襄樊地区、黄冈地区以及五峰土家族自治县1975～2009年间收治宫颈癌患者的临床资料,以患者年龄≤35岁为研究组,以同期收治的患者年龄>35岁为对照组,对患者临床资料进行回顾性分析。结果 1975～2009年间收治宫颈癌患者6736例,其中年轻宫颈癌(研究组)820例中位年龄32岁,平均(31.49±3.28)岁;对照组5916例,年轻宫颈癌占同期宫颈癌比例分别为2.7%、2.9%、3.8%、8.6%、12.5%、15.4%和17.5%,年轻宫颈癌呈上升趋势;腺癌的比例也呈上升趋势;年轻宫颈癌与对照组比较结婚年龄延后(P=0.03),孕产次低(P<0.001);原位癌及早期浸润癌比例高于对照组(P<0.001);年轻宫颈癌以接触性出血为主要症状(36.4%);2.7%患者妇科检查宫颈无明显病灶。结论年轻宫颈癌呈上升趋势,临床表现为起病较隐匿,原位癌及早期浸润癌、非鳞癌比例高。应重视对年轻女性的防癌普查,做到预防为主,早期诊断,早期治疗,以改善预后。Objective To investigate the tendency in the epidemiology,risk factors and the clinico-pathological features of cervical cancer in young women of Hubei province during the past 30 years.Methods The clinical records of 820 patients aged 35 or younger with cervical carcinoma in situ and invasive cervical cancer as a first primary malignancy during the period 1975-2009 and 5916 patients above 35 years at the same period as the controls were reviewed retrospectively.Results The average age in study group was 31.49±3.28,the median age was 32;the number of patients aged 35 or younger as percentages of total cervical cancer patients during this period was 2.7%,2.9%,3.8%,8.6%,12.5%,15.4% and 17.5%.Compared with control group,the mean marriage age was higher,while pregnancy and delivery numbers were lower（P〈0.05）.Contact bleeding was present in 36.4% cases as the most common clinical symptom in young women group,while irregular genital bleeding accounted for 47.0% in control group,the difference was significant（P〈0.001）.The main growth pattern of cervical neoplasia was cauliflower-like in both groups,which accounted for 47.1% and 54.6% respectively,but in study group,rate of carcinoma in situ and early invasive cancer was much higher than in control group（P〈0.001）.The proportion of early stage diseases and adenocarcinoma was predominant in study group（P〈0.001）.Conclusions There was an increasing tendency of cervical cancer in women aged 35 or younger during the past 30 years,early stage and non-squamous cell carcinoma predominate in young women.The clinical symptom of young women appears insidiously and requires much attention to distinguish from cervicitis.Screening should be emphasized for the purpose of early diagnosis to reduce the morbidity and mortality of cervical cancer.

关 键 词：宫颈肿瘤 年轻 临床分析 

分 类 号：R737.33[医药卫生—肿瘤] R730.231[医药卫生—临床医学]