近50年宫颈癌的发病趋势和临床特点分析(英文)

Changes in epidemiology and clinical characteristics of cervical cancer over the past 50 years

目的分析近50年宫颈癌的发病趋势和临床特点,探讨合理的治疗方案.方法对1955年1月至2004年12月收治的1 557例浸润性宫颈癌的临床和病理资料进行回顾性分析.结果近50年来宫颈癌的平均发病年龄逐渐降低,由1955～1964年的(56.27±8.45)岁降至1995～2004的(43.81±8.90)岁;年轻宫颈癌(≤35岁)的构成比由3.42%升至24.91%.同时,临床早期(Ⅰ～Ⅱ期)的比例和非鳞癌的比例则逐步升高,差异均有统计学意义(P＜0.05).不同年龄组病例的临床分期、病理类型及淋巴结转移率比较,差异均有统计学意义(P＜0.05),尤其是年轻人宫颈癌与其他年龄组比较,具有非鳞癌比例高、淋巴结转移率高和临床晚期(Ⅲ～Ⅳ期)比例高等显著特点.针对宫颈癌发病的新趋势和临床特点,改变传统的治疗模式、探索相应的治疗新方法十分必要.结论近50年宫颈癌的发病具有明显年轻化、及临床早期比例和非鳞癌比例逐步升高的趋势.与其他年龄组比较,年轻人宫颈癌具有显著不同的临床和病理特点.对于生育年龄宫颈癌的治疗应充分考虑其生殖内分泌功能的保留问题.新辅助动脉化疗是现代宫颈癌治疗的有效手段之一.

Objective To evaluate the changes in the epidemiology and clinical characteristics of cervical cancer over the past 50 years, and explore appropriate treatment corresponding to these changes. Methods The clinical and pathological data of 1557 patients with invasive cervical cancer treated between January, 1955 and December, 2004 were retrospectively analyzed. Results and Conclusions The average age of cervical cancer onset gradually decreased over the past 50 years, from 56.27±8.45 in 1955-1964 to 43.81±8.9 years in 1995-2004, whereas the ratio of young (≤35 years old) patients rose from 3.42% to 24.91%. The ratio of early clinical stage (stagesⅠ-Ⅱ) and non-squamous cancer also steadily increased (P<0.05, respectively). The tumor stage, pathological type and rate of lymph node metastasis were all significantly different among different age groups (P<0.05). In particular, the young (≤35 years old) group had evidently higher ratios of non-squamous and advanced stage (Ⅲ-Ⅳ) cancers with a higher rate of lymphatic metastasis in comparison with other age groups (P<0.01, respectively). Because of the changes in epidemiology and clinical characteristics of cervical cancer, it is necessary to modify the conventional treatment regimens and explore reasonable therapy corresponding to these changes. Preservation of reproductive endocrine function ought to be fully considered in cervical cancer treatment in women at childbearing age. Neoadjuvant intraarterial chemotherapy is an useful method for cervical cancer treatment at present.