年轻妇女宫颈癌(831例)临床病理特点和预后重点分析.docVIP

年轻妇女宫颈癌（831例）临床病理特点和预后 刘兰芳 孙海燕 浙江省肿瘤医院妇瘤科 浙江 杭州 310022 [摘要] 背景与目的：近年来宫颈癌呈年轻化趋势，探讨年轻妇女宫颈癌的临床和病理特点及预后.方法 回顾性分析831例35岁以下宫颈癌的临床资料，随机以1998年1737例35岁以上宫颈癌作对照研究，用SPSS 12.0软件统计，临床和病理特点差异用Peason chi-squoare检验，生存与复发用Kaplan-Meier 检验，P值0.05有意义。结果 35岁以下宫颈癌早期（IB+IIA）病例532例（64%），明显高于对照组（P=0.000）,非鳞癌比例高，瘤体大，（P=0.000）;早期病例术后病理具有淋巴结转移较高(P=0.000)，易浸及间质深层(P=0.005),两者的脉管累及无差异(P=0.663)；年轻组的临床期别，瘤体大小与术后病理的三大高危因素相关（P0.05），非鳞癌病例的脉管累及增加（P=0.002）。年轻组的5年生存率:早期，中晚期分别为75%和39.8%，低于对照组（P=0.000）；2年复发率高，分别为31.95%（早期）和45.48%（中晚期），年长组为15.97%和25.99%，（P=0.000）。结论 35岁以下宫颈癌具有临床期别早，非鳞癌比例高，瘤体大的临床特点和相对高危的术后病理因素，临床期别、瘤体大小是影响术后病理的重要原因，非鳞癌增加脉管累及。35岁以下宫颈癌预后差、易复发和转移。 [关键词] 宫颈癌 ； 年轻妇女 ；临床病理； 预后； The clinicapathologic characters and prognosis of cervical cancer in young women(831 cases) Liu Lan Fang, Sun Hai Yan.（Department of Gynecologic Oncology,Zhejiang Cancer Hospital,Hangzhou,310022,China） [Key words] cervical cancer ; young woman; clinicapathology ; prognosis [Abstract] Background and purpose:To determine the main characteristics in clinical and pathologic of cervical cancer in young women.and the influence of age on prognosis. Mehods: A retrospective review was performed for 831 patients less than 35 years old controled with 1737 cases older than 35. Clinical and pathologic variables including clinical stage,pathological type,tumor size,lymph node metastases(LNM),depth of invasion(DI) and lymphovascular space involvement (LVSI)were analyzed using Peason chi-squowe test.The 5-year survival and 2-year recurrent were analyzed by the Kaplan-Meier method. There is statistical significance with the p value small than 0.05.Results:The younger patients were chartacterized by a higher rate of early stage(p=0.000),non-squamous cell carcinoma(p=0.000),bulky lesion(p=0.000),LNM(P=0.000),deep stroma invasion(p=0.005),There was no different in LVSI for two groups (p=0.663).The clinical stage and tumor size were related with LNM,DI and LVSI(P0.05),non-squamous cell type was rel