宫颈癌住院患者临床特点及影响因素

Clinical characteristics and influencing factors of hospitalized patients with cervical cancer

目的宫颈癌严重威胁女性生命健康,本研究旨在探讨宫颈癌住院患者的临床特点及影响因素。方法选择大连市妇幼保健院2014-05-10-2019-05-20收治的500例宫颈癌患者作为病例组,另选取同期行体检的500名非宫颈癌检查者作为对照组。通过问卷调查收集年龄、孕次、产次、吸烟、避孕方法、家族相关遗传病史和首次性行为时间等资料,并进行分析。结果500例宫颈癌患者中,临床分期:Ⅰ期209例,ⅡA期291例;病理类型:鳞癌412例,腺癌88例;肿瘤直径:<2cm 221例,≥2cm 279例;脉管累及:有162例,无338例;淋巴转移332例。单因素分析结果显示,两组在孕次(χ^2=38.440,P<0.001)、吸烟(χ^2=58.080,P<0.001)、避孕方法(χ^2=69.370,P<0.001)、家族相关遗传病史(χ^2=82.850,P<0.001)和首次性行为年龄(χ^2=97.320,P<0.001)等方面比较,差异有统计学意义。多因素分析结果显示,宫颈癌的危险因素为吸烟史(OR=1.725,95%CI为1.161~2.562,P=0.007)、服用避孕药(OR=2.255,95%CI为1.275~3.988,P=0.005)、有家族相关遗传病史(OR=2.782,95%CI为1.597~4.844,P<0.001)、孕次≥3次(OR=1.958,95%CI为1.360~2.820,P<0.001)和首次性行为年龄≤20岁(OR=3.370,95%CI为1.566~7.253,P=0.002)。结论宫颈癌患者的病理特点为临床分期较晚,鳞癌比例较高,多无脉管累及,且淋巴结转移率较高;孕次、吸烟、避孕方法、家族相关遗传病史和首次性行为年龄为主要影响因素。

OBJECTIVE As cervical cancer seriously threatens women’s life and health,the clinical characteristics and influencing factors of hospitalized patients with cervical cancer were discussed.METHODS In this study,A total of500 patients with cervical cancer who were treated from May 10,2014 to May 20,2019 were used as the case group,and500 non-cervical cancer patients who underwent physical examination during the same period were selected as the control group.The data of age,pregnancy,birth,smoking,contraceptive methods,family related genetic history and the time of first sexual behavior were collected and analyzed.RESULTS Among 500 cases of cervical cancer,clinical stage:209 cases in stageⅠ,291 cases in stageⅡA;pathological type:412 cases of squamous cell carcinoma,88 cases of adenocarcinoma;tumor diameter:<2 cm 221 cases,≥2 cm 279 cases;vascular involvement:yes 162 cases,no 338 cases;lymphatic metastasis 332 cases.The univariate analysis showed that the differences between the two groups in terms of pregnancy(χ^2=38.440,P<0.001),smoking(χ^2=58.080,P<0.001),contraceptive methods(χ^2=69.370,P<0.001),family-related genetic medical history(χ^2=82.850,P<0.001),and age of first sexual behavior(χ^2=97.320,P<0.001)were statistically significant.The results of multivariate analysis showed that the risk factors for cervical cancer were smoking history(OR=1.725,95%CI:1.161-2.562,P=0.007),taking contraceptives(OR=2.255,95%CI:1.275-3.988,P=0.005),family history of genetic diseases(OR=2.782,95%CI:1.597-4.844,P<0.001),pregnancy≥3(OR=1.958,95%CI:1.360-2.820,P<0.001)and age of first sexual activity≤20 years(OR=3.370,95%CI:1.566-7.253,P=0.002).CONCLUSIONS The pathological characteristics of patients with cervical cancer are late clinical stage,high proportion of squamous cell carcinoma,no vascular involvement,and high lymph node metastasis rate.Pregnancy,smoking,contraceptive methods,family-related genetic medical history and the age of first sexual intercourse were the main influencing factors.