35岁以下子宫颈癌235例临床分析  

Clinical analysis of 235 cases of cervical cancer in women under 35 years old

作　　者：梁立治[1] 尧良清[1] 黄欣[1] 李孟达[1] 

机构地区：[1]中山医科大学肿瘤医院,广州510060

出　　处：《中国实用妇科与产科杂志》2000年第9期545-546,共2页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　了解 35岁以下宫颈癌的发病趋势、病因、临床表现及预后。方法　对 2 35例≤ 35岁宫颈癌的临床资料进行回顾性分析 (研究组 ) ,并随机以同期 5 0～ 5 5岁宫颈癌 96 6例作对照研究 (对照组 )。结果　≤ 35岁宫颈癌新病例所占比例 ,80年代为 5 3% (36 / 6 83) ;90年代为 14 0 % (10 1/ 72 0 ) (P <0 0 1)。研究组以接触性阴道流血为主要症状 ,占 5 3 2 % (12 5 / 2 35 ) ,对照组仅 17 9% (173/ 96 6 ) (P <0 0 1) ;HPV阳性率研究组为 45 9%(17/ 37) ,对照组为 18 5 % (2 2 / 119) (P <0 0 1)。盆腔淋巴转移率Ⅰ期两组分别为 32 3% (2 0 / 6 2 )、11 3% (36 /32 0 ) (P <0 0 1) ;Ⅱ期两组分别为 44 0 % (5 5 / 12 5 )、2 1 7% (88/ 40 6 ) (P <0 0 1)。 5年存活率研究组 0期、Ⅰ期、Ⅱ期、Ⅲ期依次为 10 0 %、74 1%、45 1%和 2 3 6 % ,对照组依次为 10 0 %、84 2 %、82 7%和 6 5 2 % ,两组对照Ⅰ期无统计学意义而Ⅱ、Ⅲ期差异显著 (P <0 0 1)。结论　 35岁以下者宫颈癌发病呈上升趋势 ,其原因可能与性传播有关。宫颈癌预后研究组较对照组为差 ,这与研究组腺癌比例增多、淋巴结转移率高有关 ,35岁以下者宫颈癌诊断时必须与宫颈糜烂相鉴别。Objective To analyse the prevalence,etiology,presentation and prognosis of cervical cancer in women under 35 years old.Methods\ The clinical information of 235 patients under 35 years old were retrospectively analysed,in control with 966 patients from 50 to 55 years old at the same time.Results\ The percentage of new cervical cancer in study group was 5 3% in 1980's(36/683),14 0% in 1990's(101/720)(P<0 01).Contact bleeding was the main symptom that occurred in 53 2%(125/235)in study group but 17 9%(173/966)in control group,(P<0 01).The rate of HPV positive was 45 9%(17/37),18 5%(22/119),respectively(P<0 01).The rate of pelvic lymph metastasis was 32 3%(20/62) and 11 3%(36/320)in stage Ⅰ,while it was 44 0%(55/125) and 21 7%(88/406)in stage Ⅱ.The survival rate of 5 years in study group was 100%,74 1%,45 1% and 23 6%in stage 0,stage Ⅰ,stageⅡ and stageⅢ. respectively.In control group it was 100%,84 2%,82 7% and 65 2%,respectively,there was no statistical significance in stage Ⅰ but it was really different in stage Ⅱ and Ⅲ(P<0 01) Conclusions\ There is an increasing prevalence of cervical cancer in women under 35 years old,which is possibly related to the sexual transition.The prognosis in study group is poorer than that in control group,which is related to the increasing proportion of adenocarcinoma and the high involvement of lymph node in study group.The key differential diagnosis is cervical erosion.

关 键 词：子宫颈肿瘤 诊断 预后 病因 

分 类 号：R737.33[医药卫生—肿瘤]