青年和中老年宫颈癌病理特征及淋巴转移情况的比较

Comparison of pathological features and lymphatic metastasis of cervical cancer in young and middle-aged patients

目的分析青年和中老年宫颈癌的病理特征及淋巴转移情况。方法选择临床确诊的宫颈癌患者172例,按发病年龄将其分为青年组和中老年组,将两组患者的基本情况、病理特征、化疗疗效、不良反应、术中情况、术后病理等结果进行比较,分析其临床特性、手术情况及淋巴转移情况。结果中老年组非鳞癌发生率小于青年组(P<0.01)。青年组中宫颈癌Ⅰ、Ⅱ期较多(70.0%),盆腔淋巴结转移52例;中老年组Ⅲ、Ⅳ期较多(71.7%),盆腔淋巴结转移41例。两组均成功实施了宫颈癌根治手术,青年组、中老年组的总有效率分别为50.0%、34.8%。两组的临床分期、化疗效果和盆腔淋巴结转移率比较差异有统计学意义(P<0.01)。青年组、中老年组药物不良反应发生率分别为48.8%、50.0%(P>0.05),两组宫旁阴道转移率、手术时间和术中出血量比较差异也无统计学意义(P>0.05)。结论青年和中老年宫颈癌的临床、病理特征有一定的差异,青年患者的新辅助化疗效果优于中老年患者,盆腔淋巴结转移率更高。

Objective To investigate the pathological features and lymphatic metastasis of cervical cancer in young and middle-aged patients.Methods A total of 172 cases diagnosed with cervical cancer were selected and divided into the Young Group and Middle-aged Group according to the onset age.The two groups were compared in terms of the basic information,pathological features,chemotherapeutic effect,adverse reactions,intraoperative information and postoperative pathologic results,and their clinical features,situation of the operation and lymphatic metastasis were analyzed.Results The Middleaged Group had the incidence of non-squamous cell cancer lower than the Young Group(P<0.01).There were more patients with Stage I or II cervical cancer in the Young Group(70.0%),and there were 52 cases in the Young Group with pelvic lymphatic metastasis.There were more patients with Stage III or IV cervical cancer in the Middle-aged Group(71.7%),and there were 41 cases in the Middle-aged Group with pelvic lymphatic metastasis.Both groups received successful radical surgery for cervical cancer,and the total effective rate of the two groups was 50.0%and 34.8%respectively.There were statistically significant differences in clinical staging,chemotherapeutic efficacy and incidence of pelvic lymphatic metastasis between the two groups(P<0.01).The incidence of adverse drug reactions was 48.8%in the Young Group and 50.0%in the Middle-aged Group(P>0.05).There was no statistically significant difference between the two groups in the rate of intrauterine vaginal metastasis,operation time and intraoperative blood loss(P>0.05).Conclusion There are some differences in the clinical and pathological features between the young group and the middle-aged group.The neoadjuvant chemotherapeutic efficacy in the young group is better than that of the middle-aged group,but there is a higher rate of pelvic lymphatic metastasis in the young group.