不同年龄段宫颈癌的临床特点分析

摘要

目的 探讨不同年龄段宫颈癌患者的临床特点.方法 对2001年1月至2012年12月就诊于首都医科大学附属北京妇产医院并确诊为宫颈癌的1911例患者进行回顾性分析,根据年龄将其分为≤35岁组(n=262)、36~49岁组(n=1031)、≥50岁组(n=618),在初潮年龄、孕产次、家族史、首发症状、临床分期、病理类型、治疗方式等方面进行统计分析.结果 发病年龄16~81岁,高发年龄段为36~49岁(53.95%).≤35岁、36~49岁患者的首发症状多为接触性出血[49.2%(129/262)、40.1%(413/1031)],≥50岁组的首发症状多为不规则阴道流血[52.3%(323/618)].≤35岁组、36~49岁组、≥50岁组的临床早期患者(ⅠA~ⅡA期)占比分别为79.4%、70.0%、49.7%.病理类型以鳞状细胞癌为主,但≤35组腺癌比例更高(12.2%),36~49岁组、≥50岁组分别为7.4%、9.7%.三个年龄段患者的病理分化程度未见明显差异.≤35岁组仅以手术为治疗方式的比例最高(48.6%),36~49岁组、≥50岁组分别为41.1%、28.6%.≤35组、36~49岁组、≥50岁组的5年生存率分别为91.1%、92.6%、87.2%.结论 宫颈癌高发年龄为36~49岁,年轻患者腺癌多见,年老患者临床晚期所占比例大,应引起重视.应扩大宫颈癌筛查范围,加强健康宣传,增强宫颈癌高发年龄人群的疾病防治意识,积极预防、早诊、早治,改善预后及生存质量.%Objective To explore the clinical features of cervical cancer in different age groups .Methods A retro-spective analysis was carried out on 1911 patients with cervical cancer diagnosed from Jan .2001 to Dec.2012 in Beijing Obstetrics and Gynecology Hospital ,Capital Medical University .All the patients were divided into three groups according to the age:a group of patients≤35 years old(n=262),a group of patients of 36-49 years old(n=1031), and a group of patients ≥50 years old(n=618).The samples in age of menarche ,the pregnancy times,the family history,the first symp-tom,clinical staging ,pathological types ,and treatment methods of the three groups were analyzed .Results The onset age range of the samples was 16-81 years old,and 36-49 years(53.95%) was the high onset age bracket .The most symptom of≤35 years old,36-49 years old patients was contact hemorrhage [40.1%(413/1031)].The first symptom of ≥ 50 years old group was irregular vaginal bleeding [52.3%(323/618)].The percentage of early clinical patients with ⅠA-ⅡA in ≤35 years old group ,36-49 years old group and ≥50 years old group was 79.4%,70.0% and 49.7%.The patho-logical type was mainly squamous cell carcinoma , however, the proportion of adenocarcinoma in ≤35 years old group (12.2%) was higher than that of the other two groups ,which was 7.4%and 9.7%respectively.Proportion of patients ≤35 years old treated only by surgery was the highest (48.6%),higher than the other two groups′41.1%and 28.6%.The 5-year survival rate of the ≤35 years old group,36-49 years old group and ≥50 years old group were 91.1%,92.6%and87.2%respectively.Conclusion The high onset age of cervical cancer is 36-49 years old,and adenocarcinoma is more of-ten seen in young patients , elderly patients should be paid more attention because they were often found in the advanced stage of cancer .We should expand the scope of cervical cancer screening ,strengthen health publicity and enhance the dis-ease prevention and treatment awareness of cervical cancer .Our aims are early diagnosis, early treatment,to improve the prognosis and quality of life .