35岁以下宫颈癌患者术后复发的危险因素及其分子病理特征分析

Analysis on the risk factors of postoperative recurrence and molecular pathological characteristics of cervical cancer in patients under 35 years old

目的探讨35岁以下宫颈癌患者术后复发的危险因素及其分子病理特征,为临床治疗和预防提供参考依据。方法回顾性分析深圳市宝安区中心医院2010年8月-2013年8月收治的45例<35岁宫颈癌及60例≥35岁宫颈癌患者的临床资料,比较两组结婚年龄、孕次、产次、吸烟史、职业及临床表现差异以分析<35岁宫颈癌的一般临床特征,随访3年,比较复发、未复发患者肿瘤大小、临床分期、盆腔淋巴结转移、宫颈浸润深度、分化程度、病理类型,观察复发的危险因素,免疫组织化学S-P法检测Survivin、CD44v6、MMP-2水平,观察复发及未复发患者分子病理学差异。结果与35岁后发病的宫颈癌患者比较,<35岁发病患者结婚年龄、吸烟差异有统计学意义(P<0.05),提示早婚、吸烟可能是<35岁宫颈癌发病的影响因素;45例患者复发率15.56%,复发、未复发患者肿瘤大小、临床分期、盆腔淋巴结转移、宫颈浸润深度比较差异有统计学意义(P<0.05),分化程度、病理类型比较差异无统计学意义(P>0.05);复发者Survivin、CD44v6、MMP-2表达水平均显著高于对照组,差异有统计学意义(P<0.05)。结论早婚、吸烟可能是<35岁宫颈癌患者发病的危险因素,肿瘤大小、临床分期、盆腔淋巴结转移、宫颈浸润深度是<35岁宫颈癌患者复发的危险因素,而Survivin、CD44v6、MMP-2异常高表达可能是<35岁宫颈癌患者复发的分子病理特征,需引起临床重视。

Objective To explore the risk factors of postoperative recurrence and molecular pathological characteristics of cervical cancer in patients under 35 years old, provide a reference basis for clinical treatment and prevention. Methods From August 2010 to Au- gust 2013, the clinical data of 45 cervical cancer patients under 35 years old and 60 cervical cancer patients aged 35 years oht and above treated in Central Hospital of Baoan District was analyzed retrospectively. Marriage age, gravidity, parity, smoking history, occupation, and clinical manifestations in the two groups were compared. The clinical characteristics of cervical cancer patients under 35 years old were ana- lyzed. The patients in the two groups were followed up for three years. The sizes, clinical stages, pelvic lymph node metastasis, depths of cervical invasion, differentiation degrees, pathological types of cervical cancer were compared between the patients with recurrence and the patients without recurrence. The risk factors of recurrence were observed, hnmunohistochemical SP method was used to detect the levels of Survivin, CIM4v6, and MMP-2. The pathological differences of patients with recurrence and patients without recurrence were observed. Results There were statistically significant differences in marriage age and smoking history between cervical cancer patients antler 35 years old and cervical cancer patients aged 35 years old and above （ P〈0. 05 ） , which indicated that early marriage and smoking were influencing factors of oncogenesis of cervical cancer patients under 35 years old. The recurrence rate was 15.56% （45 patients） . There were statisti- cally significant differences in tumor size, clinical stage, pelvic lymph node metastasis, and depth of cervical invasion between the patients with recurrence and the patients without recurrence （P〈0. 05） . There was no statistically significant difference in differentiation degree and pathological type between the patients with recurrence and the patients without recurrence （P〉0. 05 ） . The expression levels of Sm＇vivin, CD44v6, and MMP-2 in patients with recurrence were statistically significantly higher than those in patients without recurrence （ P〈0. 05 ） . （-Onclusion Early marriage and smoking may be risk factors of oncogenesis of cervical cancer patients under 35 years old. Tumor size, clin- ical stage, pelvic lymph node metastasis, and depth of cervical invasion are risk factors of recurrence of cervical cancer patients under 35 years old. The abnormal high expressions of Survivin, CD44v6, and MMP-2 may be molecular pathological characteristics of recurrence of cervical cancer patients under 35 years old, more attention should be paid to.