摘要
目的分析小于35岁妇女宫颈癌的临床表现、诊断和治疗的特点。方法回顾分析1986年1月至2006年7月收治的年轻妇女宫颈癌213例的临床资料。结果年轻妇女宫颈癌占全部宫颈癌的比例呈逐年上升的趋势;其临床表现主要为接触性阴道出血(59.62%)。0期、Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期患者的5年生存率分别为100%、79.51%、43.25%、31.71%、0。13例宫颈原位癌行宫颈锥切术,1例宫颈原位癌行LEEP术,术后均无肿瘤复发。27例宫颈癌在广泛性子宫切除手术同时行卵巢移位术,术后无1例卵巢发生癌转移。21例(12例Ⅰb2期,9例Ⅱb早期)经术前介入化疗(新辅助化疗)后行广泛性子宫切除及盆腔淋巴结清扫术,5年生存率为76.25%。5例术前放疗后行广泛性子宫切除及盆腔淋巴结清扫术,5年生存率为60.00%。两者无统计学差异(P>0.05)。结论应对筛查年轻妇女宫颈癌予以重视,对有接触性阴道出血的年轻妇女应予高度警惕。治疗年轻妇女宫颈癌时应注意保留早期患者的生育功能、卵巢功能及性功能,对局部晚期患者可用术前新辅助化疗,以提高手术切除率,改善患者的生活质量。
Objective： To analyze the clinical characters, diagnose and treatment of young women below 35 years old with cervical carcinoma. Method：The clinical information of 213 young women with primary cervical carcinoma between Jan. 1986 and July 2006 was re- viewed retrospectively. Results：The ratio of the young patients with cervical cancer was going up with years, and their primary clinical representation was contact bleeding of vagina （59. 62% ）. The 5 year survival rate for stage 0, Ⅰ ,Ⅱ, Ⅲ,Ⅳ were 100%, 79. 51% , 43.25% ,31.71% and 0% respectively. Thirteen patients with cervical carcinoma in situ were performed eonization and one patients were performed LEEP （large loop excision） ,there was no recurrence in both groups. Twenty seven patients were treated with radical hysterectomy with ovarian transposition, no ovarian metastasis was found. Twenty one patients （stage I b, n = 12; stage 11 b, n = 9 ） were treated with radical hysterectomy and pelvic lymphadeneetomy after interventional chemotherapy （ neoadjuvant chemotherapy） and 5 patients were operated on after irra- diation. The 5 years survival rate was 75.25% and 61.58% respectively. There was no significant difference between the two groups （ P 〉 0.05 ）. Condusion： The doctors must pay much more attention to screening the young women with cervical carcinoma, especially to those who suffer from the contact bleeding of vagina, and also should give attention to preserving the fertility,ovary function and sex ability of the women with early stage cervical cancer. Preoperative neoadjuvant chemotherapy can be used in patients with locally advanced cervical in order to heighten the resectable rate and improve the patients＇life quality.
出处
《现代妇产科进展》
CSCD
北大核心
2007年第4期281-284,共4页
Progress in Obstetrics and Gynecology
关键词
子宫颈肿瘤
诊断
治疗结果
预防
Cervix neoplasms
Diagnosis
Treatment outcome
Prognosis
