绝经后宫颈上皮内瘤变及宫颈癌患者的临床特点分析

Clinical characteristics of postmenopausal patients with cervical intraepithelial neoplasia and cervical cancer

目的分析绝经后宫颈上皮内瘤变(CIN)及宫颈癌(CC)患者的临床特点。方法选取2010年12月~2017年8月安徽医科大学附属巢湖医院收治的413例CIN及CC患者。回顾性分析患者的临床症状和液基薄层细胞检测(TCT)结果。根据患者是否绝经,分为绝经组和未绝经组,分别为104、309例。结果绝经组与未绝经组均以体检发现宫颈病变为主,分别为53.8%(56/104),68.9%(213/309),两组比较差异有统计学意义(χ2=7.798,P=0.005)。临床症状方面,绝经组与未绝经组中阴道不规则流血、接触性阴道出血的占比差异有统计学意义(35.6%vs.12.6%,χ2=27.307,P<0.001;2.9%vs.13.3%,χ2=8.814,P=0.003)。两组的TCT结果提示低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)阳性率均偏低,分别为22.1%(23/104),24.9%(77/309),差异无统计学意义(χ2=0.333,P=0.564)。结论绝经后CIN及CC患者的临床症状以阴道不规则流血为主,接触性阴道出血少见。

Objective To analyze the clinical characteristics of postmenopausal patients with cervical intraepithelial neoplasia(CIN)and cervical cancer(CC).Methods From December 2010 to August 2017,413 cases of CIN and CC admitted by the Department of Gynaecology of Chaohu Hospital Affiliated to Anhui Medical University were selected.The clinical symptoms and thin-cytologic test(TCT)results of the enrolled patients were analyzed retrospectively.According to whether the patient was menopausal,it was divided into menopausal group and non-menopausal group,104 and 309 cases respectively.Statistical analysis was performed using SPSS 24.0 software.Results Both the menopausal group and the unmenopausal group were mainly found cervical lesions by physical examination,53.8%(56/104)and 68.9%(213/309),respectively,and the difference between the two groups was statistically significant(χ2=7.798,P=0.005).In terms of clinical symptoms,the proportion of irregular vaginal bleeding and contact vaginal bleeding in the menopausal group and the unmenopausal group was significantly different and statistically significant(35.6%vs.12.6%,χ2=27.307,P<0.001;2.9%vs.13.3%,χ2=8.814,P=0.003).TCT results of patients in the two groups indicated that the positive rates of low-grade squamous intraepithelial lesion(LSIL)and high-grade squamous intraepithelial lesion(HSIL)were relatively low,which were 22.1%(23/104)and 24.9%(77/309),respectively,and the differences were not statistically significant(χ2=0.333,P=0.564).Conclusion The clinical symptoms of postmenopausal CIN and CC patients are main vaginal irregular bleeding,contact vaginal bleeding is rare.