马拉维艾滋病合并宫颈癌104例临床分析

Clinical analysis of 104 patients with AIDS and cervical cancer in Malawi

目的了解和分析马拉维艾滋病合并宫颈癌患者的临床特点。方法对104例艾滋病合并宫颈癌患者的临床资料进行回顾性分析。结果在104例患者中,年龄23~52岁,平均39.5岁。CD4+淋巴细胞计数17~483/mm^3。宫颈癌分期与CD4+淋巴细胞计数关系如下:宫颈原位癌4例,CD4+为360~483/mm3;宫颈癌ⅠA1~ⅠB2期30例,CD4+为183~400/mm^3;ⅡA1~ⅡB期36例,CD4+为87~359/mm^3;ⅢA~ⅢB期18例,ⅣA~ⅣB期16例,CD4+为17~163/mm^3;平均数为(104.00±4.26)/mm^3,其中CD4+<200/mm^3有72例。住院期间死亡23例,死亡率占22.12%(23/104),以CD4+<100/mm^3最为常见。随访半年,死亡36例,死亡率达34.62%(36/104)。结论艾滋病合并宫颈癌患者免疫功能低下,发病年轻化,死亡率高,死亡与多因素有关。高度认识艾滋病危害,避免感染艾滋病病毒(HIV),加强宫颈癌患者早期筛查,做到早预防、早诊断、早治疗,能延长患者生存时间。

Objective To investigate and analyze the clinical characteristics of patients with AIDS and cervical cancer in Malawi. Methods Clinical data of 104 patients with AIDS and cervical cancer were analyzed retrospectively. Results The age of 104 patients ranged from 23 to 52 years old with an average of 39.5 years. C1M ＋ lymphocyte count was among 17 - 483/mm3. Correlation between cervical cancer staging and CD4 ＋ lymphocyte count was as follows ： 4 cases of cervical carcinoma in situ with CIM ＋ of 360 - 483mm3 , 30 cases of cervical cancer at IA1 -IB2 phase with CD ＋ of 183-400/mm3 , 36 cases at ⅡA1-ⅡB phase with CD4 ＋ of 87 - 359mm3 , 18 cases at Ⅲ A-ⅢB period and 16 eases at IVA-IVB period with CD4 ＋ of 17 -163/mm3. The average count was 104.00 ＋4.26/mm3, including 72 cases with CD4 ＋ 〈200/mm3. Twenty-three cases died during hospitalization, and the mortality rate was 22.12% （23/104）. CIM ＋ 〈 100/mm3 was most common. Follow-up was conducted for half year, and the mortality rate was 34.62% （36/104）. Conclusion The patients of AIDS with cervical cancer are hypoimmunity, and the incidence shows younger trend. Mortality is high and most is influenced by many factors. To entirely understand the harm of HIV/AIDS, to avoid HIV infection, to strengthen early screening for cervical cancer patients and to prevent, diagnose and cure early can prolong patient＇ s survival.