宫颈癌的青年化与早期发现

Trend of increasing incidence and early diagnosis of cervical cancer in younger women

目的 :探讨年轻宫颈癌患者 (≤ 35岁 )发病情况和宫颈癌的筛查方法。方法 :回顾分析2 2 1例宫颈癌病例及用阴道、子宫颈、宫颈管 ( Vagina,cervix,endocervix,VCE)三步取材加 TBS( The bathesda system,TBS)分类法门诊筛查宫颈癌或宫颈上皮内瘤变 ( Cervical intraepithelialneoplasia,CIN)患者。结果 :宫颈癌患者的发病年龄已由 1 975 - 1 984年间 ( 5 4 .3± 9.5 )岁下降到现在的 ( 4 2 .2± 9.4)岁 ( P<0 .0 0 5 )。年轻宫颈癌患者 (≤ 35岁 )的构成比从 1 975 - 1 984年间的 4.8%升至目前的 34.1 % ( P<0 .0 0 5 )。84.1 %的年轻患者为 0～ a 期。在门诊对年轻宫颈疾病患者筛查中发现意义不明非典型鳞状上皮细胞增生 2 0例 ,低度鳞状上皮内瘤样增生 30例 ,高度鳞状上皮内瘤样增生 2 0例 ,宫颈鳞癌 1 9例和宫颈腺癌 2例 ,并经活组织病理学检查所证实。结论 :宫颈癌患者发病年龄呈明显的年轻化趋势 ;VCE加 TBS能有效地诊断 CIN和宫颈癌。

Objective:To study on the incidence of cervical cancer in younger women(≤35 years old) and the diagnostic screening methods. Methods: A retrospective analysis of 221 cases with cervical cancer during current 20 years in the first hospital was performed and a screening of cervical cancer and/or cervical intraepithelial neoplasia(CIN)in outpatient had done by integration of vagina cervix endocervix sampling: into The Bathesda system (TBS). Results:The age mean of the patients with cervical cancer had been reduced to 42.2±9.4 years old at present from 54.3±9.5 years old durign period from 1975 to 1984 ( P <0.005). The age constituent ratio of patients under 35 years old with cervical carcinoma rose to 34.1% at present ( P <0.005) from 4.8% during 1975 to 1984 and the disease stage was at 0～Ⅱ a in 84.1% of younger patients(≤35 years old). Among young outpatients with cervical disease, there were 20 cases of atypical squamous cell of undetermined significance(ASCUS),30 cases of low grade squamous intraepithelial lesion(LSIL),20 cases of high grade squamous intraepithelial lesion(HSIL),19 cases of squamous cell carcinomas and 2 cases of adenocarcinomas of cervix were found. Conclusion: The present data shows a much noticeable trend of an increasing incidence of cervical cancer in young women; a screening of cervical cancer by integration of VCE into TBS is useful in early diagnosis of cervical cancer and CIN.