2175例宫颈癌患者住院病历资料分析

Analysis on the medical records of 2 175 hospitalized patients with cervical cancer

目的:探讨宫颈癌患者的发病年龄、组织学病理类型、临床分期及接受治疗情况,对宫颈癌的流行病学研究及宫颈癌的早期预防宣传教育提供临床依据。方法:顺序选取2002年1月～2008年12月江西省妇幼保健院肿瘤科收治的宫颈癌患者2 175例作为研究对象,对其进行回顾性研究,就宫颈癌患者就诊时的年龄构成分布、组织病理类型、临床分期及治疗手段等进行分析,临床分期采用国际妇产科联盟(FIGO)(1994年)。结果:2 175例宫颈癌患者中接受宫颈癌手术治疗992例,接受根治性放疗或放化疗患者1 183例。研究对象中,按照1994年FIGO临床分期,其中ⅠA1期17例,ⅠA2期28例,ⅠB1期491例,ⅠB2期361例,ⅡA期151例,ⅡB期606例,ⅢA期28例,ⅢB期487例,Ⅳ期6例。按照宫颈组织病理类型划分,其中宫颈鳞癌1 887例(86.76%),宫颈腺癌216例(9.93%),腺鳞癌30例(1.38%),鳞腺癌22例(1.01%),其他类型共计20例(0.92%)。患者年龄按照≤25岁、26岁～、31岁～、36岁～、41岁～、46岁～、51岁～、56岁～、>60岁共分为9个年龄组,各年龄组宫颈癌患者例数分别为19例(0.87%),78例(3.59%),195例(8.96%),389例(17.88%),464例(21.33%),385例(17.70%),293例(13.47%),150例(6.90%),202例(9.29%)。其中35岁及以下年轻宫颈癌患者共计292例,占全部患者的13.42%。中晚期宫颈癌(ⅡB期以上)患者多于早期宫颈癌患者。结论:宫颈癌发病呈年轻化趋势,发病高峰年龄为36～50岁,提高妇女对宫颈癌早期筛查的宣传教育工作可降低中晚期宫颈癌的发病率。

Objective： To explore the onset age, histopathological types, clinical stages, and treatment of the patients with cervical cancer, provide a clinical basis for epidemiological research, publicity and education of early prevention of cervical cancer. Methods ： A total of 2 175 patients with cervical caner who were treated in tumor department of the hospital from January 2002 to December 2008 were selected in sequence as study objects, then a retrospective study was conducted, the constitution and distribution of age, histopathological types, clinical stages, and treatment of the patients were analyzed; FIGO （1994） was adopted for clinical staging. Results： Among 2 175 patients with cervical cancer, 992 patients received surgery, and 1 183 patients received radical radiotherapy or radiotherapy combined with chemotherapy. According to FIGO clinical staging in 1994, 17 cases with stage Ⅰ A1, 28 cases with stage Ⅰ A2, 491 cases with stage Ⅰ B1, 361 cases with stage Ⅰ B2, 151 cases with stage ⅡA, 606 cases with stage ⅡB, 28 cases with stage ⅢA, 487 cases with stage ⅢB, and 6 cases with stage Ⅳ were included into the study objects. According to histopathological types of cervical cancer, 1 887 cases （86. 76% ） with cervical sqnamous cell carcinoma, 216 cases （9. 93% ） with cervical adenocarcinoma, 30 cases （ 1.38% ） with cervical adenosquamous carcinoma, 22 cases （1.01%） with cervical squamous adenocarcinoma, and 20 cases （0. 92% ） with other types were included into the study objects. The patients were divided into nine groups according to age： ≤25 - year - old group （ 19 cases, 0. 87% ） , 26- 30- yearold group （78 cases, 3.59% ）, 31 -35 -yearold group （195 cases, 8.96% ）, 36 -40 -year- old group （389 cases, 17.88% ） , 41 -45 - year - old group （464 cases, 21.33% ） , 46 - 50 - year - old group （385 cases, 17.70% ） , 51 - 55 - year - old group （293 cases, 13.47% ） , 56 - 60 - year - old group （ 150 cases, 6. 90% ） , and 〉 60 - year - old group （202 cases, 9.29% ） . Two hundred and ninety - two patients were 35 years old or less than 35 years, accounting for 13.42%. The number of patients with cervical cancer in intermediate and advanced stages （above stage ⅡB ） was more than that of patients with cervical cancer in early stage. Conclusion： The onset of cervical cancer shows a tendency toward young, the peak age is 36 - 50 - year, improving publicity and education of early screening of cervical cancer among women can reduce the prevalence of cervical cancer in intermediate and advanced stages.