宫颈癌及癌前病变相关危险因素分析

Risk factors of cervical cancer and precancerous lesions

目的研究宫颈癌及癌前病变相关危险因素。方法选取宫颈上皮内瘤样病变（CIN）及宫颈癌患者2 000例为研究对象,进行问卷调查;另选取同期接受健康检查育龄妇女病理证实无CIN病变者1 000例作为对照人群。结果 CINⅠ、CINⅡ、CINⅢ均集中在20~49岁,20~39岁最为集中;宫颈癌主要集中在30~49岁及≥50岁年龄段,以30~49岁构成比例最高。CINⅠ组、CINⅡ组和CINⅢ组在20~29、30~39岁构成比,两两比较差异有统计学意义（P〈0.05）,其余年龄段两两比较差异均无统计学意义（P〉0.05）;CINⅠ组、CINⅡ组和CINⅢ组与宫颈癌组在20~29、40~49、≥50岁构成比比较差异有统计学意义（P〈0.05）,其余年龄段两两比较差异均无统计学意义（P〉0.05）。Logistic回归分析显示,人乳头状瘤病毒（HPV）感染、初次性生活年龄、户籍情况及性生活年限与宫颈癌及癌前病变的发生存在明显相关性（P〈0.05）。结论宫颈癌及癌前病变相关危险因素主要有初次性生活年龄过小、HPV感染、性生活年限过长及非本地户口等。

Objective To study the risk factors of cervical cancer and precancerous lesions. Methods A total of 2 000 patients with cervical intraepithelial neoplasia（ CIN） or cervical cancer were enrolled in this study; at the same time,the1 000 reproductive life women who underwent physical examination and without CIN confirmed by pathology were selected as the control population. Results The CIN Ⅰ,CIN Ⅱ and CIN Ⅲ patients were mainly concentrated in the 20- 49 years old,and 20- 39 years old were the most. The cervical cancer patients were mainly concentrated in 30- 49 years old and ≥50 years old,and 30- 49 years old were the most. There was statistic difference of the constituent ratio of CIN Ⅰ,CIN Ⅱ and CIN Ⅲpatients number in 20- 29,30- 39 years among CIN Ⅰ group,CIN Ⅱ group and CIN Ⅲ group（ P〈0. 05）; there was no statistic difference at the other age among the three groups（ P〉0. 05）. There was statistic difference of the constituent ratio of CIN Ⅰ,CIN Ⅱ,CIN Ⅲ and cervical cancer patients number in 20- 29,40- 49,≥50 years between CIN Ⅰ group,CIN Ⅱgroup,CIN Ⅲ group and cervical cancer group（ P〈0. 05）; there was no statistic difference at the other age among the groups（ P〉0. 05）. The logistic regression analysis showed that the human papilloma virus（ HPV） infection,the age of first sexual life,censue register and sex life were significantly correlated with cervical cancer and precancerous lesions（ P〈0. 05）. Conclusion The HPV infection,initial sexual age is too small,sexual life too long,non-local censue register etc,were the mainly risk factors of cervical cancer and precancerous lesions.