年轻妇女宫颈癌临床病理因素与预后的关系

The relationship between clinical pathological variables and prognostic factor in cervical cancer in young women

目的 :探讨年轻妇女宫颈癌的临床病理因素及与预后的关系。方法 :回顾分析 1 983至 1 997年收治的≤ 3 5岁宫颈癌 1 42例病理检查资料 ,非随机选择 1 995年收治的>3 5岁宫颈癌 3 1 8例作为对照。用Fisher’s精确概率法检验临床病理差异 ,Log rank检验生存率差异 ,Cox比例风险模型分析预后因素。结果 :年轻组Ⅰb+Ⅱa 期病例占 66% ,期别属偏早期。年轻组的临床病理表现为瘤体大、非鳞癌比例高 ,与对照组差异有显著性(P <0 .0 5 ) ,其他高危因素 ,如病理分级、间质浸润、淋巴结转移及脉管累及 ,两组差异无显著性 (P >0 .0 5 )。年轻组各期 5年生存率均低于对照组 ,但差异无显著性 (P >0 .0 5 )。结论 :年轻妇女宫颈癌除了有瘤体大、非鳞癌比例高的特点外 ,无其他预后不良的病理特征。与对照组相比 ,年轻组 5年生存率无明显下降 ,年轻不是宫颈癌预后的不良因素。

Objective:To explore the relationship between clinical pathological variables and prognostic factor in cervical cancer in young women.Methods:Between 1983 and 1997,142 cases of cervical cancer under 35 years of age were treated.318 cases of cervical cancer over 35 years of age were chosen unrandomly as control group.The Fisher's exact test was used to compare clinical pathological variables,the Log rank test was used to compare the 5 year survival of the two groups at each stage,the Cox stepwise regression model was used to analyze prognostic factors.Results:The cases of stage Ⅰ b+Ⅱ a disease of young group account for 66%.Bulky lesions and the rate of nonsquamous carcinoma showed significant differences.But there were no significant differences in grade,stroma invasion,lymph node metastasis and lymph vascular space invasion.5 year survival of different stages of young group was lower than that of control group,but without significant statistical differences.Conclusion:Cervical cancer in young women has feature of bulky tumor and higher rate of nonsquamous carcinoma.Other pathological variables are same in two groups and there is no obvious low 5 year survival rate in young women.So cervical carcinoma in young women does not have worse prognosis than in other groups.