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目的探讨青年妇女患宫颈癌的临床病理及预后特征。方法回顾性分析134例35岁以下年轻宫颈癌患者的临床资料及预后特点,并与100例35岁以上的对照组宫颈癌患者进行对比研究。结果研究组与对照组的临床对比发现,两组患者的HPV感染史、初次性交≤20岁及避孕药使用史相比较差异有统计学意义(χ2=10.22、5.83、5.24,P﹤0.05)。与对照组比较,研究组患者中Ⅰb+Ⅱa患者所占比例明显高于对照组,而≥Ⅱb的患者则明显少于对照组,差异有统计学意义(χ2=6.42,P﹤0.05)。研究组患者中肿瘤大小≥4cm的患者所占比例明显低于对照组,差异有统计学意义(χ2=7.85,P﹤0.05)。研究组患者中腺癌所占比例明显高于对照组,差异有统计学意义(χ2=8.11,P﹤0.05)。研究组患者的淋巴结转移发生率明显高于对照组,差异有统计学意义(χ2=4.53,P﹤0.05)。研究组患者中深间质浸润发生率明显高于对照组,差异有统计学意义(χ2=8.36,P﹤0.05)。两组患者均获得5年以上的随访,研究组临床早期患者(Ⅰa~Ⅱa)和晚期患者(≥Ⅱb)的5年生存率、2年内复发率与对照组相比差异均有统计学意义(χ2=9.21、9.72、5.63、4.57,P﹤0.05)。通过COX回归多因素分析研究组患者5年生存率与临床病理的相关性发现临床分期浸润深度及淋巴结转移时影响研究组患者5年生存率的因素(P﹤0.05),而病理类型、肿瘤大小及HPV感染则不是影响因素(P﹥0.05)。结论 35岁以下宫颈癌患者具有临床期别早、病理恶性程度低、瘤体大、腺癌比例高及易转移浸润的的临床特点和相对高危的术后病理因素。35岁以下宫颈癌预后较差,而临床分期、浸润深度及淋巴结转移是影响其预后的独立因素。
Objective To investigate the clinicopathological and prognostic features of young women with cervical cancer. Methods A retrospective analysis of 134 cases of younger than 35 years of age cervical cancer patients with clinical data and prognosis characteristics, and 100 cases of 35-year-old control group of cervical cancer patients were compared. Results The clinical comparisons between the study group and the control group showed that there was significant difference between the two groups in the history of HPV infection, the first intercourse of ≤20 years and the history of contraceptive use (χ2 = 10.22,5.83,5.24, P <0.05). Compared with the control group, the proportion of patients with Ⅰb + Ⅱa in the study group was significantly higher than that in the control group, while the patients with ≥ Ⅱb were significantly less than the control group (χ2 = 6.42, P <0.05). The proportion of patients with tumor size ≥ 4 cm in study group was significantly lower than that in control group (χ2 = 7.85, P <0.05). The proportion of adenocarcinoma in the study group was significantly higher than that in the control group (χ2 = 8.11, P <0.05). The incidence of lymph node metastasis in study group was significantly higher than that in control group (χ2 = 4.53, P <0.05). The incidence of deep stromal infiltration in the study group was significantly higher than that in the control group (χ2 = 8.36, P <0.05). Both groups were followed up for more than 5 years. The 5-year survival rates in the early clinical stage (Ⅰa-Ⅱa) and the late stage (≥Ⅱb) in the study group were significantly different from those in the control group χ2 = 9.21,9.72,5.63,4.57, P <0.05). Correlation between 5-year survival rate and clinicopathological characteristics in COX regression study groupThe five-year survival rate (P <0.05) of patients in study group was significantly correlated with clinical stage invasion and lymph node metastasis, but pathological type, tumor size And HPV infection is not an influencing factor (P> 0.05). Conclusions Cervical cancer patients under 35 years old have clinical features of early clinical stage, low malignant degree, large tumor size, high proportion of adenocarcinoma and easy metastasis and invasion, and relatively high risk postoperative pathological factors. Cervical cancer under 35 years old is poor prognosis, and clinical stage, depth of invasion and lymph node metastasis are independent prognostic factors.