502例宫颈癌发病趋势与临床特征分析

目的分析宫颈癌发病趋势与临床特点，为早期发现病例提供依据。方法收集医院2006—2011年就诊的宫颈癌临床病例资料，采取趋势分析法（F）分析就诊病例变化趋势。结果共收治宫颈癌患者502例，年病例从2009年的49例增加至2011年的118例。各年的住院病例占医院各种住院病例的0．25％。0．40％。占妇产科住院病例的4．51％～8．95％，均呈上升趋势（P〈0．05）；年龄由2006年的（54．20±12．16）岁降至2011年的（47．50＋13．01）岁（F=127．91，P〈0．01），2006年病例以50～岁组居多，占32．65％，2007年起，以40一岁组病例为多，占32．61％～46．60％，并呈逐年上升趋势（如17．68，P〈0．05）；鳞状上皮癌占86．06％，腺癌占13．94％，原位癌、Ⅰa—Ⅰb1、Ib2-Ⅱa和Ⅱb期以上病例所占比例依次为5．58％、19．72％、27．29％和47．41％。各年均以Ⅱb期以上病例最多。占39．83％～61．22％，其次是Ib2—Ⅱa期，占20．41％。35．59％；临床表现阴道不明原因出血者占94．42％，阴道分泌液增多者占96．61％，腰部与下腹酸痛占34．46％，临床检查宫颈糜烂占85．66％、肥大占49．00％、萎缩占16．14％，有赘生物占61．16％。结论宫颈癌临床病例逐年上升，且呈年轻化趋势，病例发现较晚，主要临床症状为阴道分泌物增多和不明原因出血。应定期进行妇科检查，加强宫颈癌的早期发现与治疗。

Prevalence trends and clinical characteristics of 502 cases of cervical cancer

Objective To analyze the clinical characteristics and trends of cervical cancer so as to provide the scientific evidence for the early detection of cases. Method General and clinical data of patients with cervical cancer in the hospital during 2006 to 2011 were collected and analyzed for the disease occurrence. Results 502 patients with cervical cancer were treated from 2006 to 2011. The number of cases was found to increase from 49 to 118 each year. The proportion of patients with cervical cancer in all hospital was 0.25%-0.40%, and the proportion of cervical cancer admitted to the obstetrics department was increasing from 4.51% to 8.95%（P〈0.05）. The proportion of rural people was 81.47%. The age of the patients was reduced from （54.20±12.16） in 2006 to （47.50＋13.01） in 2011 （F=127.91,P〈 0.01 ）. The proportion of patients in the age group of 50 was 32.65% in 2006. The proportion of patients in the age group of 40 was increased from 32.61% （2007） to 46.60% （2011） （F=17.68, P〈0.05）. Pathological analysis showed that 86.06% was squamous cell carcinoma and 13.94% was adenocarcinoma. The proportion of carcinoma in situ, Ⅰ a- Ⅰ bl, Ⅰ b2-Ⅱa and llb was 5.58%, 19.72%, 27.29%, and 47.41%, respectively. The proportion of vaginal unexplained bleeding, vaginal secretions increase, waist and abdominal pain in clinical manifestations was 94.42%, 96.61%, and 34.46%, respectively. The proportion of cervical erosion, hypertrophy, atrophy, and neoplasm in the clinical samples was 85.66%, 49.00%, 16.14%, and 61.16%, respectively. Conclusions There was an increase in the incidence of cervical cancer and the age of the disease onset was decreasing. The disease was usually diagnosed at the later stage of the development. The major clinical symptoms were the increase in vaginal secretion and unexplained bleeding. Early gynecological examination should be carried out to reduce the disease incidence.