宫颈残端癌的致病因素及预防分析  

The pathogenic factors and prevention measures of cervical stump cancer

作　　者：任伟 赵素芬 史慧星 钱雅丽 崔小娟 张永存 REN Wei;ZHAO Sufen;SHI Huixing(Department of Gynecology,Xingtai General Hospital,North China Medical and Health Group,Hebei,Xingtai 054000,China;不详)

机构地区：[1]华北医疗健康集团邢台总医院妇科,河北省邢台市054000 [2]河北医科大学第二医院

出　　处：《河北医药》2022年第18期2855-2858,共4页Hebei Medical Journal

摘　　要：目的探讨宫颈残端癌的致病因素,为临床工作中此类疾病的预防提供依据。方法回顾性分析河北医科大学第二医院2000年1月至2020年1月收治的56例宫颈残端癌患者的病例资料,总结其临床特点、致病因素、子宫次全切除术前及术后宫颈癌筛查情况等。结果56例宫颈残端癌患者平均发病年龄(52.14±5.28)岁,均为真性残端癌。行子宫次全切除术的平均年龄(40.14±3.11)岁。宫颈残端癌术前49例患者行宫颈HPV检测,其中HPV16阳性、HPV18阳性者占62.50%。56例患者平均孕次(3.8±0.5)次,平均产次(3.5±0.6)次。首次性生活年龄均较早,平均(21.8±0.7)岁,性伴侣数≥2个者占58.93%。文化程度小学及以下文化水平为主,占57.14%,经济收入均较低。56例患者子宫次全切术后性生活均未使用避孕套。结论人乳头状瘤病毒感染(尤其是HPV16)是宫颈残端癌主要致病因素,初始性生活早、流产及分娩次数多、经济状况较差及文化水平较低、术后性生活防护不到位等也是宫颈残端癌发生的高危因素。宫颈残端癌重点在预防,在临床工作中,正确选择子宫次全切除术,术前进行宫颈TCT及HPV联合筛查,术后长期随访,以期减少宫颈残端癌发生。Objective To investigate the pathogenic factors of cervical stump cancer,so as to provide evidence for the prevention of such diseases in clinical practice.Methods The clinical data about 56 patients with cervical stump cancer who were treated in our hospital from January 2000 to January 2020 were retrospectively analyzed,and the clinical characteristics,pathogenic factors,cervical cancer screening status before and after subtotal hysterectomy were investigated.Results The onset average age of the 56 patients with cervical stump cancer was(52.14±5.28)years,and the mean age of subtotal hysterectomy was(40.14±3.11)years.Forty-nine patients underwent cervical HPV detection before surgery,of whom,the cases with positive HPV16 accounted for 62.50%.The average number of pregnancies in the 56 patients was(3.8±0.5)times,and the average parity was(3.5±0.6)times.And the age of first sexual intercourse was earlier,with an average age being(21.8±0.7)years,and the number of sexual partners≥2 accounted for 58.93%.The primary education level and below were dominant,accounting for 57.14%,and the economic income was relatively lower.None of the 56 patients used condoms during sex after subtotal hysterectomy.Conclusion Human papillomavirus infection(especially HPV16)is the main pathogenic factor of cervical stump cancer,and early initial sexual life,frequent abortion and delivery,poor economic situation and low educational level,and inadequate sexual life protection after operation are the high risk factors of cervical stump cancer.Therefor it is necessary to select correctly the,subtotal hysterectomy in clinical practice,and to perform cervical TCT and HPV screening before operation,and to carry out long-term follow-up after operation to reduce the occurrence of cervical stump cancer.

关 键 词：宫颈残端癌 子宫次全切除术后 HPV感染 

分 类 号：R730.1[医药卫生—肿瘤]