年轻Ⅰa2~Ⅱa2期子宫颈癌患者的构成比变化趋势及临床病理特征分析  被引量:16

Trend in proportion and clinicopathological characteristics of young women with stageⅠa2 toⅡa2 cervical cancer

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作  者:王伟[1] 郝敏[1] 陈春林[2] 刘萍[2] 凌斌[3] 康山 陆安伟 王武亮[6] 赵卫东[7] 朱前勇 赵岳阳 赵宏伟[9] 靳双玲[10] 倪妍 郎景和[12] Wang Wei;Hao Min;Chen Chunlin;Liu Ping;Ling Bin;Kang Shan;Lu Anwei;Wang Wuliang;Zhao Weidong;Zhu Qianyong;Zhao Yueyang;Zhao Hongwei;Jin Shuangling;Ni Yan;Lang Jinghe(Department o f Obstetrics and Gynecology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Obstetrics and Gynecology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Obstetrics and Gynecology,China-Japan Friendship Hospital,Beijing 100029,China;Department of Gynecology,Fourth Hospital,Hebei Medical University,Shijiazhuang 050019,China;Department of Obstetrics and Gynecology,Shenzhen Hospital,Southern Medical University,Shenzhen 518101,China;Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China;Department o f Obstetrics and Gynecology,Anhui Provincial Hospital,Hefei 236048,China;Department of Obstetrics and Gynecology,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Gynecology,Shanxi Provincial Cancer Hospital,Taiyuan 030001,China;Department of Obstetrics and Gynecology,Peace Hospital Affiliated with Changzhi Medical College,Changzhi 046000,China;Department of Obstetrics and Gynecology,Yuncheng Central Hospital in Shanxi Province,Yuncheng 044000,China;Department o f Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区:[1]山西医科大学第二医院妇产科,太原030001 [2]南方医科大学南方医院妇产科,广州510515 [3]中日友好医院妇产科,北京100029 [4]河北医科大学第四医院妇科,石家庄050019 [5]南方医科大学深圳医院妇产科,518101 [6]郑州大学第二附属医院妇产科,450014 [7]安徽省立医院妇产科,合肥236048 [8]河南省人民医院妇产科,郑州450003 [9]山西省肿瘤医院妇科,太原030001 [10]长治医学院附属和平医院妇产科,046000 [11]山西省运城市中心医院妇产科,044000 [12]中国医学科学院北京协和医院妇产科,100730

出  处:《中华妇产科杂志》2019年第10期666-672,共7页Chinese Journal of Obstetrics and Gynecology

基  金:国家科技支撑计划(2014BAI05B00);国家卫生和计划生育委员会公益性行业科研专项(201402010);国家自然科学基金(81972452);山西省重点研发计划(201803D31121);山西省卫生和计划生育委员会科研课题(2015038);广州市科技计划(158100075)。

摘  要:目的探讨年轻Ⅰa2~Ⅱa2期子宫颈癌患者的构成比变化趋势及临床病理特征.方法收集2004年1月-2016年12月共13年间中国11省市37家三级甲等医院收治的46313例子宫颈癌患者的临床病理资料,按照2018年国际妇产科联盟(FIGO)的临床分期标准进行重新分期,选择期别为Ⅰa2~Ⅱa2期、行B型或C型子宫切除+盆腔淋巴结切除术的子宫颈癌患者共19041例,其中年龄≤35岁的年轻患者1888例(≤35岁组),年龄>35岁的中老年患者17153例(>35岁组),分析2004-2016年的13年间年轻Ⅰa2~Ⅱa2期子宫颈癌患者的构成比变化趋势,并比较两组患者发病相关因素、临床病理特征的差异.结果(1)2004-2016年的13年间,≤35岁组患者的构成比呈显著下降趋势(χ^2趋势=119.543,P<0.01);在≤35岁组患者中,2004-2010年间的构成比明显高于2011-2016年间[分别为12.6%(820/6484)、8.5%(1068/12557);χ^2=82.101,P<0.01].(2)与>35岁组患者比较,≤35岁组患者的初潮年龄较早、结婚年龄较晚、孕次和产次较少,分别比较,差异均有统计学意义(P<0.01);而两组间高危型HPV阳性率比较,差异则无统计学意义(P>0.05).(3)与>35岁组患者比较,≤35岁组患者中临床分期Ⅰ期(分别为68.5%、83.4%)、外生型肿瘤(分别为56.2%、63.2%)、非鳞癌(分别为12.0%、13.9%)所占比例均较高,分别比较,差异均有统计学意义(P<0.05);而两组间低分化所占比例比较,差异则无统计学意义(P>0.05).(4)与>35岁组患者比较,≤35岁组患者中切缘阳性(分别为1.8%、1.1%)、间质浸润深度>1/2(分别为50.9%、40.1%)所占比例均较低,分别比较,差异均有统计学意义(P<0.05);而宫旁浸润、肿瘤直径、淋巴脉管间隙浸润方面,两组间分别比较,差异均无统计学意义(P>0.05).结论2004-2016年的13年间,年轻的Ⅰa2~Ⅱa2期子宫颈癌患者的构成比呈显著下降趋势.相对于中老年患者,年轻的Ⅰa2~Ⅱa2期子宫颈癌患者的初潮年龄较早、Ⅰ期和非鳞癌比�Objective To analyze the 13 years trend in proportion,risks factors and clinicopathological characteristics of young women with stageⅠa2 to Ⅱa2 cervical cancer by using multi-center data of cervical cancer in China.Methods The clinicopathological data of 46313 patients with cervical cancer treated from 37 hospitals in China were obtained from January 2004 to December 2016.Using clinical and pathologic data,each patient′s stage was reclassified by the 2018 International Federation of Gynecology and Obstetrics(FIGO)staging system.A total of 19041 patients were selected according to the following criteria:FIGO stageⅠa2 to Ⅱa2,underwent type B or C radical hysterectomy and pelvic lymphadenectomy.All the patients were divided into two groups:the study group of 1888 patients aged 35 years or younger and the control group of 17153 patients aged over 35 years.The 13 years trend in proportion of young women with stageⅠa2 toⅡa2 cervical cancer,risks factors and clinicopathological characteristics of two groups were retrospectively analyzed.Results(1)The total number of hospitalized patients with stageⅠa2 toⅡa2 cervical cancer increased annually.However,a downward trend of patients aged 35 years or younger was observed(P<0.01).The constituent ratio of patients aged 35 years or younger was significantly greater during 2004-2010 than that during 2011-2016[12.6%(820/6484) and 8.5%(1068/12557),respectively;χ^2=82.101,P<0.01].(2)Compared with patients aged over 35 years,patients aged 35 years or younger had an earlier age at menarche,a later age at marriage,lesser gravida and parity(all P<0.01).The positive rate of high-risk HPV infection was not statistically different between two groups(all P>0.05).(3)The proportions of stageⅠ,exophytic type and non-squamous histological type in patients aged 35 years or younger were clearly higher than those in patients aged over 35 years(83.4%vs 68.5%,P<0.01;63.2%vs 56.2%,P<0.01;13.9%vs 12.0%,P<0.05,respectively).Whereas the poor differentiation ratios of the two groups

关 键 词:宫颈肿瘤 年龄因素 乳头状瘤病毒感染  鳞状细胞 肿瘤侵润 肿瘤分期 

分 类 号:R73[医药卫生—肿瘤]

 

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