年轻宫颈癌患者的临床、病理特征及预后的影响因素分析  

Clinical features, pathology and prognostic factors of young cervical cancer

作　　者：高慧莉[1] 郭幼军 

机构地区：[1]北京市石景山医院妇产科,100040

出　　处：《中国综合临床》2017年第2期167-170,共4页Clinical Medicine of China

摘　　要：目的探讨年轻（年龄〈35岁）宫颈癌患者的临床、病理特征，以及影响预后的危险因素。 方法选取年龄〈35岁的年轻宫颈癌患者120例作为研究组，选取同期收治的年龄≥35岁的中老年宫颈癌患者120例作为对照组。比较两组患者的临床特征、病理特点，对影响预后的相关因素进行单因素及多因素分析。结果研究组患者接触性阴道出血、月经紊乱、轻度宫颈糜烂、HPV感染阳性、保存卵巢手术的比例明显高于对照组[60.8%（73/120）、47.5%（57/120），30.0%（36/120）、11.7%（14/120），57.5%（69/120）、23.3%（28/120），81.7%（98/120）、60.0%（72/120），52.5%（63/120）、25.8%（31/120）]，差异均有统计学意义（χ2值分别为4.30、12.23、29.90、13.63、17.91，P均〈0.05）。不规则阴道出血的发生率明显低于对照组[6.7%（8/120）、15.8%（19/120）]，差异有统计学意义（χ2＝5.05，P〈0.05）。两组病理类型均以鳞癌为主，研究组非鳞癌比例高于对照组[27.5%（33/120）、15.0%（18/120）]，差异有统计学意义（χ2＝5.60，P〈0.05）。研究组的盆腔淋巴结转移率为68.3%（82/120），高于对照组的55.0%（66/120），差异有统计学意义（χ2＝4.49，P〈0.05）。影响年轻宫颈癌患者预后的多因素分析显示，临床分期、病理类型、宫颈浸润深度以及盆腔淋巴结转移是影响年轻宫颈癌患者预后的独立危险因素（Wald χ2值分别为4.02、6.93、8.92、10.87，OR值分别为3.22、5.57、6.84、5.48，95%CI分别为1.13～8.62、1.24～11.75、2.82～17.35、1.88～12.35，P均〈0.05）。结论年轻宫颈癌患者与中老年宫颈癌患者在临床特征、病理特点等方面存在一定的差异。应不断加强年轻女性宫颈癌的普查和防治，对临床分期高、非鳞癌、宫颈浸润深以及盆腔淋巴结转移阳性的患者应提高警惕，进行重点的排查和预防，提高个体化治疗及防控体系。ObjectiveTo investigate the clinical features, pathology and prognostic factors of young patients with cervical cancer less than 35 years old.MethodsOne hundred and twenty cases cervical cancer less than 35 years old were selected as study group, while 120 cases of cervical cancer over 35 years old as control group in the same period.The clinical features and pathology were compared between two groups and risk factors were analyzed.ResultsThe proportion of contact vaginal bleeding, menstrual disorders, mild cervical erosion, HPV infection, and the number of pregnancy preserving ovarian surgery in study group were significantly higher than that in control group（60.8%（73/120） vs.47.5%（57/120）, 30.0%（36/120） vs.11.7%（14/120）, 57.5%（69/120） vs.23.3%（28/120）, 81.7%（98/120） vs.60.0%（72/120）, 52.5%（63/120） vs.25.8%（31/120））, the differences were statistically significant（χ2=4.30, 12.23, 29.90, 13.63, 17.91; P〈0.05）. The incidence of irregular vaginal bleeding in study group was significantly lower than that in control group（6.7%（8/120） vs.15.8%（19/120））, the differences was statistically significant（χ2=5.05, P〈0.05）. The main pathological types of two groups were squamous cell carcinoma, non squamous cell carcinoma rate in study group was significantly higher than that in control group（27.5%（33/120） vs.15.0%（18/120））, the differences was statistically significant（χ2=5.60, P〈0.05）. Pelvic lymph node metastasis rate in study group was 68.3%（82/120）, significantly higher than that in control group（55.0%（66/120）, χ2=4.49, P〈0.05）. Multivariate analysis of prognostic factors in young patients with cervical cancer showed that clinical stage, pathological type, depth of cervical invasion and pelvic lymph node metastasis were independent risk factors for the prognosis of young patients with cervical cancer（Wald χ2=4.02, 6.93, 8.92, 10.87; OR=3.22, 5.57, 6.84, 5.48; 95%CI=1.13-8.62, 1.24-11.75, 2.82-17.35, 1.88-12.35, P〈0

关 键 词：宫颈癌 临床特征 病理特点 预后 

分 类 号：R737.33[医药卫生—肿瘤]