摘要
目的探讨不同年龄ⅠA2~ⅡA2期宫颈癌妇女的临床和病理特点。方法回顾性分析丽水市人民医院2015年3月至2019年3月收治的113例ⅠA2~ⅡA2期宫颈癌患者的资料,研究对象根据年龄分为<35岁组(52例)和≥35岁组(61例),比较两组患者的临床和病理特点。结果 <35岁组患者初次性生活年龄显著低于≥35岁组患者,差异有统计学意义(t=6.257,P<0.05),首发临床症状中接触性出血发生率显著高于≥35岁组患者(χ~2=6.221,P<0.05),而阴道不规则流血发生率显著低于≥35岁组患者(χ~2=4.634,P<0.05),<35岁组患者吸烟率显著高于≥35岁组患者,差异有统计学意义(χ~2=4.855,P<0.05)。两组患者初潮年龄、孕次、产次比较差异均无统计学意义(t值分别为1.314、1.023、0.978,均P>0.05),且高危型人乳头状瘤病毒(HR-HPV)阳性率比较差异无统计学意义(χ~2=0.002,P>0.05)。<35岁组腺癌比例、临床分期Ⅰ期比例和切缘阳性比例均显著高于≥35岁组,差异有统计学意义(χ~2值分别为4.285、5.305、4.744,均P<0.05)。两组患者肿瘤生长方式、病理分化程度、宫旁浸润、宫颈浸润深度和淋巴脉管间隙浸润比较差异均无统计学意义(χ~2值分别为0.803、1.159、0.407、1.090、0.972,均P>0.05),两组患者肿瘤生长方式均以外生型为主,<35岁为46.15%,≥35岁组为40.98%。结论性生活过早、吸烟在<35岁年龄组宫颈癌发生中起重要作用,年轻宫颈癌患者肿瘤类型中腺癌比例增加,且易发生切缘阳性,应引起临床重视。
Objective To explore the clinical and pathological features of stageⅠA2~ⅡA2 cervical cancer among different ages.Methods The clinical data of 113 patients with stageⅠA2~ⅡA2 cervical cancer in People’s Hospital of Lishui City from March 2015 to March 2019 were retrospectively analyzed.The subjects were divided into the group less than 35 years old(52 cases)and the group over 35 years old(61 cases)according to the age,the clinical and pathological features of the two groups were compared.Results The age of the first sexual behavior in the group less than 35 years old was significantly lower than that in the group over 35 years old(t=6.257,P<0.05).In the initial symptoms,the incidence of contact hemorrhages in the group less than 35 years old was significantly higher than those in the group over 35 years old(χ~2=6.221,P<0.05),but the incidence of vaginal irregular bleeding was significantly lower than that in the group over 35 years old(χ~2=4.634,P<0.05).The smoking rate in the group less than 35 years old was significantly higher than those in the group over 35 years old(χ~2=4.855,P<0.05).There was no significant difference in menarche age,gravity and parity between the two groups(t=1.314,1.023,0.978,respectively,all P>0.05),and no significant difference in positive rate of high-risk human papillomavirus(HR-HPV)between the two groups(χ~2=0.002,P>0.05).The proportion of adenocarcinoma,stage I of clinical stage and the positive proportion of incisional margin in the group less than 35 years old were significantly higher than those in the group over 35 years old(χ~2=4.285,5.305,4.744,respectively,all P<0.05).There was no significant difference in tumor growth pattern,pathological differentiation degree,peri-uterine infiltration,cervical infiltration depth and lymphatic intervascular infiltration between the two groups(χ~2=0.803,1.159,0.407,1.090,0.972,respectively,all P>0.05).The tumor growth pattern of the two groups was mainly exogenic,which account for 46.15%in the group less than 35 years old and 40.98%in the group over 35 years old.Conclusion Early sexual behavior and smoking play an important role in the occurrence of cervical cancer in patients less than 35 years old.Among the tumor types of young cervical cancer patients,the proportion of adenocarcinoma is increased with higher possibility of positive incisional margin,which should be paid more attention.
作者
张小燕
廖旭慧
吴勤丽
张海
ZHANG Xiaoyan;LIAO Xuhui;WU Qinli;ZHANG Hai(Department of Pathology,People's Hospital of Lishui City,Zhejiang Lishui 323000.China)
出处
《中国妇幼健康研究》
2020年第7期961-964,共4页
Chinese Journal of Woman and Child Health Research
关键词
宫颈癌
临床特点
病理
预后
影响因素
cervical cancer
clinical features
pathology.prognosis
influencing factors
