年轻妇女宫颈癌38例临床分析

目的探讨年轻妇女宫颈癌的发病趋势、临床表现、病理特征和治疗特点。方法对2003-01～2008-12我院收治的年龄435岁宫颈癌患者38例（研究组）的临床资料进行回顾性分析，并随机与同时期〉35岁宫颈癌患者34例（对照组）作对照分析。结果年轻妇女宫颈癌发病率有明显上升趋势；研究组孕次、产次均较对照组低，但无统计学意义；临床表现研究组与对照组均以接触性出血为主，其次为不规则阴道流血；在肿瘤类型方面，两组均以外生型为主，但是研究组以巨块型为主，占63．1％，与对照组相比差异有统计学意义（P〈0．05）；临床分期上，研究组和对照组均以早期癌（临床分期≤Ⅱa期）居多，分别占94．7％（36／38）、91％（31／34），两者相比差异无统计学意义（P〉0．05）；病理类型、组织学分级、淋巴结转移与对照组相比差异无统计学意义（P〉0．05），均以中分化鳞癌为主要病理类型。研究组38例，予手术治疗34例，30例保留一侧或双侧卵巢并移位于同侧上腹部（P〈0．05），34例行盆腔淋巴结清扫，淋巴结转移率为20．6％，以闭孔淋巴结为最常见。对照组34例，予手术治疗31例，10例保留一侧或双侧卵巢并移位于同侧上腹部（P〈0．05），31例行盆腔淋巴结清扫，7例有淋巴结转移，淋巴结转移率为22．5％，以闭孔淋巴结为最常见，两组淋巴结转移率比较差异无统计学意义（P〉0．05）。结论宫颈癌患者发病有明显年轻化趋势；研究组患者临床分期以早期癌为主，接触性出血为年轻妇女宫颈癌的危险信号，淋巴结转移较少见，诊断上应提高对年轻妇女宫颈癌的警惕性，尽量做到早期诊断和治疗，主张提倡对已婚妇女的普查，及时发现及诊疗癌前病变和早期癌。治疗时应注意保留早期患者的卵巢功能，提高生活质量。

Clinical analysis of 38 young women with cervical carcinoma

Objective To study the clinical characteristics,pathological characteristics and treatment of cervical carcinoma in younger women（ ≤35 years old）with invasive cervical carcinoma. Methods The clinical informations（ clinical symptons, pathological characteristics, metastasis of lymph nodes and treatments） of 38 younger women （ ≤35 years old） with invasive cervical carcinoma who were treated from January 2003 to November 2008 （the study group ） were retrospectively analyzed, and compared with 34 women （over 35 years） with invasive cervical earcinamoa in the same period（ the control group）. Results There was an increasing prevalence of invasive cervical carcinoma in women under 35 years old. In the study group, the pregnancy and delivery times were lower, but the difference was not statistically significance（ P 〉 0. 05 ）. The percentage of contact bleeding was higher in women in the study group and the control group,the main type was outside. Clinical stage was mainly the early stage and the percentage of II a were 94. 7% （36/38） ,91% （31/34） in the study group and the control group, but the difference was not statistically significance （P 〉 0. 05 ）. There were no significant differences between the study group and the control group in pathologic stage and grade, lymph node metastasis. Thirty-four patients in study group were treated while 30 of them were reserved one or two ovary and the ovaries were transplanted to the upper abdomen on the same side （ P 〈 0. 05 ）. The pelvic lymph nodes in 31patiens of young women were cleared. The rate of metastasis was 22. 5%, and the obturator lymph nodes was the first place to be metastasized. Conclusion The prevalence of the cervical carcinoma tends to be younger. Attention should be paid to young women. Contact bleeding is a dangerous signal of cervical carcinoma in young women. And cervical carcinoma in young women can easily be misdiagnosised or not be diagnosised in young women. It is important keep attention to it in young women. Ovatian function in patients with earlier stage should be kept during opration.