年轻妇女宫颈癌临床特征分析

Clinical analysis of invasive cervical carcinoma in young women

目的分析35岁以下年轻妇女宫颈癌的发病趋势、临床特征变化等。方法对1998年-2003年我院收治的67例年轻宫颈癌患者(研究组)的临床资料进行回顾性分析,并随机选择同期有完整随访资料的82例年龄大于35岁的宫颈癌患者作对照组,分析两组资料间临床特点、病理及预后之间的差异。结果1998年-2003年6年间年轻宫颈癌的构成比呈现逐渐上升趋势,分别为11.11%、13.63%、15.21%、17.28%、20.89%、23.58%;研究组以接触性出血为主要临床表现,占79.10%(53/67),与对照组的40.24%(33/82)比较有显著性差异(P<0.01);初诊时67例患者中30例(44.77%)曾在基层医院以宫颈炎、宫颈糜烂行对症治疗,12例(17.91%)以月经紊乱行调经治疗,1例术前诊断为子宫肌瘤,术后病检证实为宫颈癌;病理特点研究组内生型比率较对照组明显增高,二者比较有显著性差异;病理类型及组织类型上二者无明显差异,均以鳞癌为主(97.01%、95.21%),但术后淋巴病理检查显示对照组淋巴转移率高于研究组,有显著性差异。结论年轻宫颈癌患者的构成比呈现明显上升趋势,宫颈癌年轻化趋势明显;年轻宫颈癌临床症状较为隐匿,容易漏诊和误诊。

Objective To analyse the prevalence, clinical feature of invative cervical carcinoma under 35 years old in Ningxia. Methods The clinical information of 67 patients under 35 years old were respectively analyzed to investigate the difference in clinical and patholegical feature, in control with 82 patients from 36 - 78 years old in same time. Results The percentage of younger patients in studying group was increased gradually in six years from 1998 - 2003 Contact bleeding was the clas,sic symptom in 79.10 % （53/67）in studying group but 40.24 % in control group（ P 〈0.01）. Irregular bleeding was the main symptom in control group. 30 cases in 67 patients （44.7%） were diagnosed as cervivicitis incorrectly in first visiters, 12cases（ 17.91% ） as menstrual disorder, one case as hysteromyoma preoperative diagnosis. Ectogenesis profile was the main shape in two groups.The most common histological and pathological type was squamous cell carcinoma in two groups（97.01%,95.21% ）, but the rate of pelvic lymphnede metastasis was significantly higer than control group after post- operation（ P 〈 0. 01 ）. Conclusion Constituent ratio for young patients revealed an increasing trend from 11.11% in 1998 to 23.58% in 2003.The main clinical symptom in young patients were contract bleeding followed by sheltered symptom.And it is easier to be missed or misdiagnosised.