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目的对36岁以下宫颈癌患者的病理学特征进行调查,并对患者的手术治疗情况进行研究。方法选择2011年5月至2015年5月间收治的50例36岁以下青年宫颈癌患者,将其作为观察组,同时选择同期50例≥36岁宫颈癌患者,将其作为对照组,比较两组患者的病理学特征,同时调查两组患者的手术效果。结果两组患者临床表现主要为接触性阴道出血和阴道出血,但观察组接触性阴道出血率为70.0%(35/50)明显高于对照组的50.0%(25/50),比较差异有统计学意义(P<0.05),其余症状比较无明显差异(P>0.05)。观察组患者分期早于对照组,组间比较均存在明显差异(P均<0.05)。两组患者病理类型都以鳞癌为主,观察组患者腺癌发生率明显高于对照组[14.0%(5/50)vs 2.0%(1/50),P<0.05]。观察组主要采用广泛子宫切除术联合淋巴结清扫术、阴道延长术和附件移位术进行治疗;对照组主要采用广泛子宫全切术联合双附件切除术、盆腔淋巴结清扫术进行治疗。观察组、对照组患者术后1年疾病复发率分别为22.0%、10.0%,两组比较存在明显差异(χ~2=6.52,P<0.05)。术后1年,观察组、对照组病死率分别为12.0%、1.0%,两组比较差异有统计学意义(χ~2=5.84,P<0.05)。结论 36岁以下青年女性宫颈癌病理学与≥36岁女性宫颈癌患者有较大不同,患者预后较差,尽早接受诊断和治疗是改善患者预后的关键。
Objective To investigate the pathological features of cervical cancer patients under 36 years old and to study the surgical treatment of patients. Methods Fifty patients with cervical cancer under the age of 36 who were admitted to our hospital from May 2011 to May 2015 were selected as the observation group and 50 patients with cervical cancer ≥ 36 years of age were selected as the control group, Group of patients with pathological features, while investigating the two groups of patients with surgical results. Results The clinical manifestations of the two groups were mainly contact vaginal bleeding and vaginal bleeding. However, the rate of contact vaginal bleeding in the observation group was 70.0% (35/50), which was significantly higher than that in the control group (50.0%, 25/50) Significance (P <0.05), the remaining symptoms showed no significant difference (P> 0.05). The observation group had earlier stage than the control group, there were significant differences between the two groups (all P <0.05). The incidence of adenocarcinoma in the observation group was significantly higher than that in the control group [14.0% (5/50) vs 2.0% (1/50), P <0.05]. The observation group was treated with extensive hysterectomy combined with lymphadenectomy, vaginal prolongation and attachment shift. The control group was treated with extensive hysterectomy combined with double-attachment excision and pelvic lymph node dissection. The recurrence rates of the observation group and the control group were 22.0% and 10.0% respectively at 1 year after operation, with significant difference between the two groups (χ ~ 2 = 6.52, P <0.05). One year after operation, the case fatality rates in the observation group and the control group were 12.0% and 1.0%, respectively. There was significant difference between the two groups (χ ~ 2 = 5.84, P <0.05). Conclusion The pathology of cervical cancer in young women under 36 years of age is quite different from that of women with cervical cancer of ≥36 years. The prognosis of patients with poor prognosis is poor. Early diagnosis and treatment are the keys to improve the prognosis of patients.