宫颈腺癌与宫颈鳞状细胞癌患者筛查史特点的对比分析  

Comparison of characteristics of cervical cancer screening history between cervical adenocarcinoma and cervical squamous cell carcinoma

作　　者：叶敏娟[1] 李静 陈梓菲 何俊贤 陈利发 张宇[1] Ye Minjuan;Li Jing;Chen Zifei;He Junxian;Chen Lifa;Zhang Yu(Department of Gynecology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院妇产科,广州510630 [2]深圳市妇幼保健院妇科,深圳518047

出　　处：《新医学》2024年第4期311-316,共6页Journal of New Medicine

摘　　要：目的对比分析宫颈腺癌与宫颈鳞状细胞癌患者的宫颈癌筛查史特点,初步评价宫颈癌筛查方案对宫颈腺癌癌前病变的筛查效力。方法回顾性分析117例宫颈腺癌和712例宫颈鳞状细胞癌患者的临床资料,对比2组不同病理类型宫颈癌患者在既往宫颈癌筛查史上的差异。结果宫颈腺癌患者曾参与宫颈癌筛查的比例为24.5%,高于宫颈鳞状细胞癌患者的6.8%(P<0.001),且宫颈腺癌患者进行规范或高于规范频次筛查的比例为18.4%,高于宫颈鳞状细胞癌患者的2.8%(P<0.001)。宫颈鳞状细胞癌患者由于症状就诊的比例为91.6%高于宫颈腺癌患者的79.1%(P<0.001),早期宫颈腺癌患者中因宫颈筛查结果异常就诊的比例为24.6%,高于早期宫颈鳞状细胞癌患者的11.1%(P=0.004),宫颈腺癌中早期患者因筛查结果异常就诊的比例为24.6%,高于晚期患者的4.0%(P=0.022)。结论宫颈癌筛查方案对宫颈鳞状细胞癌的癌前病变筛查效力较高,对宫颈腺癌的癌前病变筛查效力较低,但有助于宫颈腺癌早期病例的诊断,因此应重视宫颈癌筛查,宫颈癌筛查方案有待进一步优化。Objective To comparatively analyze the characteristics of cervical cancer screening history between patients with cervical adenocarcinoma and cervical squamous cell carcinoma,and to preliminarily evaluate the efficacy of cervical cancer screening for precancerous lesions of cervical adenocarcinoma.Methods Clinical data of 117 patients with cervical adenocarcinoma and 712 patients with cervical squamous cell carcinoma were retrospectively analyzed,and the differences in cervical cancer screening history were statistically analyzed between two groups.Results The proportion of cervical adenocarcinoma patients receiving cervical cancer screening was 24.5%,significantly higher than 6.8%of those with cervical squamous cell carcinoma(P<0.001).The proportion of cervical adenocarcinoma patients receiving regular screening or above was 18.4%,significantly higher than 2.8%of those with cervical squamous cell carcinoma(P<0.001).The proportion of symptom-detected cervical squamous cell carcinoma was 91.6%,significantly higher than 79.1%of their counterparts with cervical adenocarcinoma cell carcinoma(P<0.001).The proportion of screening-detected stageⅠ-ⅡA cervical adenocarcinoma was 24.6%,significantly higher than 11.1%of those with screening-detected stageⅠ-ⅡA cervical squamous cell carcinoma(P=0.004).The proportion of screening-detected stageⅠ-ⅡA cervical adenocarcinoma was 24.6%,significantly higher than 4.0%of those with screening-detected stageⅡB-Ⅳcervical adenocarcinoma(P=0.022).Conclusions Current cervical cancer screening regimen yields higher efficacy for precancerous lesions of cervical squamous cell carcinoma compared with cervical adenocarcinoma.However,it still contributes to the diagnosis of early cervical adenocarcinoma.Therefore,extensive attention should be paid to cervical cancer screening.Cervical cancer screening regimen remains to be further optimized.

关 键 词：宫颈腺癌 宫颈鳞状细胞癌 宫颈癌筛查 癌前病变 

分 类 号：R737.33[医药卫生—肿瘤]