摘要
背景与目的:近30年来国内外报道宫颈癌总体发病率有所下降,但有年轻化倾向,35岁以下妇女宫颈癌发病率呈上升趋势,关于35岁以下妇女宫颈癌的预后尚有争议。本研究旨在探讨35岁以下妇女宫颈癌的临床病理特点及预后。方法:回顾性分析831例35岁以下宫颈癌患者(年轻宫颈癌组)的临床资料,随机选取1998年1737例35岁以上宫颈癌患者作对照研究(对照组),用SPSS12.0软件统计,临床和病理特点差异用Peason chi-squoare检验,5年生存与2年复发率用Kaplan-Meier检验,P<0.05为差异有显著性。结果:35岁以下宫颈癌患者中,早期(ⅠB+ⅡA)病例532例,占64.00%,显著高于对照组37.80%(P=0.000);非鳞癌比例研究组为14.90%,显著高于对照组的6.80%(P=0.000);瘤体直径≥4cm,研究组占52.00%,对照组占30.40%,差异有显著性(P=0.000);早期病例中研究组术后淋巴结转移和间质深层浸及率分别为33.46%和51.88%,对照组分别为23.93%和39.94%,差异均有显著性(P<0.05),研究组脉管累及率为37.03%,对照组为38.26%,两者比较差异无显著性(P=0.663);研究组的临床期别,瘤体大小与术后病理的三大高危因素相关(P<0.05),年轻宫颈癌患者病理类型只与脉管累及相关,鳞癌患者脉管累及为40.40%,非鳞癌患者的77.65%,差异有显著性(P=0.002)。研究组早期和中晚期5年生存率分别为75%和39.8%,低于对照组的84.38%和54.13%,(P=0.000);研究组2年复发率高,分别为31.95%(早期)和45.48%(中晚期),对照组为15.97%和25.99%,(P=0.000)。结论:35岁以下宫颈癌具有临床期别早,非鳞癌比例高,瘤体大的临床特点和相对高危的术后病理因素,临床期别、瘤体大小是影响术后病理的重要原因,非鳞癌病理类型增加脉管累及。35岁以下宫颈癌预后较差、易复发和转移。
Background and purpose： Several prior studies have evaluated that the overall incidence of cervical cancer has decreased in the past 30 years, while it seems that the age of mortality is younger, especially young women under 35 years old. The prognosis of cervical cancer in young women still needs to be determined. The purpose of this study was to determine the main clinicopathologic characteristics of cervical cancer in young women aged under 35 years and the influence of age on prognosis. Methods： A retrospective review was performed for 831 patients under 35 years old , 1 737 cases over 35 years old was used as a control group. Clinical and pathologic variables including clinical stage, pathological type, tumor size, lymph node metastases（ LNM）, depth of invasion（DI） and lymphovascular space involvement （LVSI） were analyzed using Peason chi-squowe test. The 5-year survival and 2-year recurrence rates were analyzed by Kaplan-Meier method. Results： The younger patients were characterized by a higher rate of early stage with 64% vs 37.8% in control group（ P =0. 000）, non-squamous cell carcinoma were 14.90% in the study group and 6.80% in the control group（ P = 0. 000）, bulky lesion were 52.00% vs 30.44% （ P =0. 000）, LNM were 33.46% vs 23.93% （ P = 0. 000）, deep stroma invasion（DSI） were 51.88% vs 39.94% （ P = 0. 005）, There was no significant difference in LVSI for two groups with 37.03% in the young group and 38.26% in the control group （ P =0. 663）. The clinical stage and tumor size of young patients were related with LNM, DI and LVSI（ P 〈0.05）, the pathologic type in the study group was only related with LVSI, LVSI in squamous cell carcinoma was 40.40% vs 66.00% in non-squamous cell carcinoma （P =0. 002）. The 5-year survival rate was 75% and 39.8% in early and advanced stage in young patients, 84.38% and 54.13% in control group respectively（ P =0. 000）. The 2-year recurrence rate for two groups were 31.95% vs 15.97% （P = 0. 000） in early stage, 4
出处
《中国癌症杂志》
CAS
CSCD
2008年第4期298-301,共4页
China Oncology
关键词
宫颈癌
年轻妇女
临床病理
预后
cervical cancer
young woman
clinicopathology
prognosis
