上海市区妇科“三癌”诊治分析

The analysis of cervical endometrial and ovarian carcinomas in Shanghai urban

回顾调查了１９８８年１月１日至同年１２月３１日上海市区妇科＂三癌＂（宫颈癌、子宫内膜癌、卵巢恶性肿瘤）４１１例。结果：＂三癌＂的发病率分别为４．０５、４．４５、５．３７／１０万。平均发病年龄分别为６４．２、５８．８、５０．７岁。临床分期：宫颈癌≥Ⅱ期占８７．７％、内膜癌Ⅰ期占６０．８％、卵巢癌Ⅱ～Ⅲ期占４３．８％。病理：宫颈鳞癌占８５．５％，内膜腺癌占８１．５％，卵巢上皮癌占８１．５％。治疗方法：宫颈癌以放疗为主，内膜癌及卵巢癌以手术为主。

For the purpose of upgrading the diagnosis and treatment level of cervical, endometrial and ovarian carcinomas (three-Ca.),a retrospective study of 494 cases was made in Shanghai urban in 1988. The result showed that the inoidences of cervical, endometrial and ovarian carcinomas were 4.05/ 100,000, 4.45/100,000, and 5.37/100, 000, re pectively.The mean age of them were 64.2, 58.8 and 50.7 years, respectively. From clinical and pathological classification: cervical Ca.>Ⅱ was 87:7%,it was mostly squamous cell cancer which was accounted for 85.5%; endometrial Ca.Ⅰ was 59.5%, it was mostly glandular cancer which was accounted for 81.5.%; ovarian Ca.Ⅱ-Ⅲ was 41%, it was mostly epithelioma which was accounted for 81.5%. Among them, about 90% cases were found at hospital clinic because of irregular vaginal bleeding and other gynecological symptoms. Only 16 cases (3.9%) were found by gynecological mass screening.The diagnosis of threeCa.which was delayed for over 3 months was 41%, 52.8% and 35.8%,respectively, the main reason for it was lack of basic knowledge of common gynecological diseases and poor diagnostic level. The medical treatment for these diseases:radiation therapy for cervical Ca. surgical operation for both endometrial and ovarian Ca.and aided with chemotherpy or radiation therapy .According to the result of the study, it was urgent to upgrade the quality of mass screening, to popularize knowledge of selfcare to the women, to raise the diagnostic level at primary hospital and to try to work out a standard diagnosis and treatment method for the diseases.