老年女性Ⅰ和Ⅱ期宫颈癌临床分析

目的 探讨老年宫颈癌的临床特征,相关危险因素及对预后的影响. 方法 选择1997年1月至2006年12月按照国际妇产科联盟(FIGO)1991年临床分期标准为Ⅰ、Ⅱ期宫颈癌,并行广泛子宫切除术同时盆腔淋巴结切除术的患者163例,按年龄分老年、中年、青年组,回顾性分析各组的临床病理资料、复发预后情况. 结果 老年宫颈癌的临床分期Ⅱ期病例居多,占78.7%(37/47),中年组为61.7%(58/94),青年组为59.1%(13/22),差异有统计学意义(均P<0.01).老年宫颈癌非鳞癌发生率占8.5%(4/47),高于中年组5.3%(5/94),低于青年组18.2%(4/22),差异有统计学意义(均P<0.05).老年宫颈癌组织分化以中分化居多78.7%(37/47),低分化较少4.3%(2/47),差异有统计学意义(均P<0.01).老年宫颈癌淋巴结转移低,占8.5%(4/47),中年组27.7%(26/94),青年组40.9%(9/22),差异有统计学意义(均P<0.01).各年龄组复发率相似,复发病例中老年组病死率高,占85.7%(12/14),中年组73.1%(19/26),青年组50.0%(4/8),差异无统计学意义. 结论 老年宫颈癌的临床分期晚,非鳞癌发生率较高,组织分化以中分化居多低分化较少,淋巴结转移少.

Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group 5.3%(5/94)]and lower than that in young group 18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.