31例无症状宫颈癌患者临床特征分析

Clinical analysis on asymptomatic cervical cancer in 31 cases

目的：探讨无症状宫颈癌患者的发病情况及临床特征，为宫颈癌早期预防提供一定的临床依据。方法：收集2003年1月～2012年12月皖南医学院附属弋矶山医院妇科收治的宫颈癌861例，其中无症状宫颈癌患者31例，运用回顾性分析方法对其发病情况及临床病理特征进行比较分析。结果：收治的31例无症状宫颈癌患者中城镇患者占64．52％；中学学历者占61．29％；孕次≥3次者占61．29％；而产次＜2次者占61．29％；两组比较，无症状组的平均年龄较有症状组小，差异有统计学意义（P＜0．05）；无症状组宫颈癌患者的临床分期为ⅠA期、无宫旁转移、肿瘤直径≤4 cm、宫颈肌层浸润深度≤1／2、无淋巴结转移及无脉管累及所占的比例均较有症状组者高，差异均具有统计学意义（P＜0．05）；而两组宫颈癌的病理类型无明显差异（ P＞0．05）。结论：无症状宫颈癌患者发病年龄小，临床分期期别低，非鳞癌类型较少，宫旁转移率较低，肿瘤直径≤4 cm者与肌层浸润深度≤1／2者较多见，淋巴结转移率及脉管累及率均较低。

Objective：To investigate the prevalence and clinical features of cervical neoplasia in asymptomatic patients for clinical evidences to plan early preventive strategy for this entity .Methods：Retrospective analysis was performed in 31 asymptomatic women out of 861 cases of cervical cancer undergone treatment in our hospital between January 2003 and December 2012,with regard to the prevalence and pathological properties.Results：In 31 patients with asymptomatic cervical cancer,64.52% were urban residents,61.29% had only middle school education,61.29% were gravida III and 61.29%,gravida II.Patients with asymptomatic cervical neoplasia were younger on average than those with symptoms,and the difference was significant（P〈0.05）.Higher incidence was found in asymptomatic group,including the rate of stage ⅠA cervical cancer,without parametrial invovlment,tumor diameter less than 4 cm, depth of stromal invasion less than 1/2,without lymph node metastasis and no vascular involvement（P〈0.05）,and yet,the pathologic types were not sig-nificantly different（P〈0.05）.Conclusion：Asymptomatic cervical cancer is screened in younger women,which leads to lower stage of this tumor,fewer cases of non-squamous carcinoma,less parametrial involvement,tumor diameter being less than 4 cm and invasion depth to the cervical stroma being less than 1/2 as well as lower incidence of lymphatic metastasis and vascular involvement.