广西壮族自治区8009例妇科恶性肿瘤住院患者的构成特点及变化趋势

目的 了解广西壮族自治区近20年间妇科恶性肿瘤住院患者的构成特点及变化趋势。方法 对1985-2004年间广西壮族自治区23家医院收治的8009例妇科恶性肿瘤患者的临床资料进行统计分析。结果 （1）构成比：妇科恶性肿瘤中,构成比排在前4位的分别是宫颈癌、卵巢恶性肿瘤、子宫内膜癌、恶性滋养细胞肿瘤。其中,1985-1989年、2000-2004年宫颈癌住院患者的构成比呈上升的趋势,从17．48％上升到49．25％,两者比较,差异有统计学意义（P〈0．01）;恶性滋养细胞肿瘤呈下降的趋势,从30．69％下降到7．34％,两者比较,差异有统计学意义（P〈0．01）;而卵巢恶性肿瘤、子宫内膜癌、外阴阴道恶性肿瘤、子宫肉瘤等比较,差异则无统计学意义（P〉0．05）。（2）好发年龄：近10年,宫颈癌的发病年龄明显前移,从≥60岁前移到〈40岁,两者比较,差异有统计意义（P〈0．05）。（3）地域和职业分布：前10年宫颈癌患者主要集中于城市,构成比为67．1％;后10年却逐渐向农村转移,农村宫颈癌患者构成比达52．6％。（4）手术病理分期或临床分期：妇科恶性肿瘤患者就诊时大多数已经处于Ⅱ、Ⅲ、Ⅳ期,中晚期（Ⅲ、Ⅳ期）的构成比多在60％以上。结论 （1）应重点加强对宫颈癌的普查防治工作,同时也要加大对其他妇科肿瘤的防治力度。（2）加大对相应肿瘤标志物、新的诊治方法的发现和研究力度,提高早期诊治率。

Constitutive characteristics and change trend of gynecological malignant tumors in 8009 hospitalized patients in Guangxi Zhuang Autonomous Region

OBJECTIVE: To investigate the constitutive characteristics and the change trend of gynecologic malignant tumors in hospitalized patients in Guangxi Zhuang Autonomous Region over the recent 20 years. METHODS: Clinical data of 8009 in-patients who suffered from gynecologic malignant tumors in 23 hospitals from 1985 to 2004 in Guangxi Zhuang Autonomous Region were analyzed, with respect to the tumor types and change trend. RESULTS: (1) The leading 4 types of malignant tumors were cervical cancers, ovarian cancers, endometrial cancers, and malignant trophoblastic tumors according to the constitutive ratios of the tumors. The constitutive ratio of cervical cancer patients rose year by year, from 17.48% during the 1985-1989 period to 49.25% during the 2000-2004 period (P < 0.01). While the constitutive ratio of malignant trophoblastic tumors dropped year by year. The changes of ovarian cancer, endometrial cancer, vulvar and vaginal carcinomas, and sarcoma of the uterus were not obvious (P > 0.05). (2) The occurring age of cervical cancers became younger obviously, from > or = 60 years old dropped to < 40 years old. (3) Cervical cancers were found mainly in urban residents in the former 10 years, the constitutive ratio being 67.1%; while in the latter 10 years it gradually shifted to rural residents, accounting for 52.6% of the total gynecological tumors. (4) Patients were usually at stages II, III, IV when they visited a doctor for their diseases. Especially for ovarian cancer, malignant trophoblastic tumors, sarcoma of the uterus, these patients were in the intermediate or advanced stage when they were diagnosed, mainly because of lack of obvious symptoms. The constitutive ratio of these advanced patients was over 60%. CONCLUSIONS: We should strengthen the screening program of cervical cancer, and pay more attention to prevention and control of other gynecological reproductive organ tumors at the same time. On the other hand, we should explore better tumor markers, new methods of diagnosis and treatment to improve early diagnosis and treatment of gynecologic malignant tumors.