摘要
目的:探讨10年来宫颈腺癌住院患者发病趋势及临床特点。方法:2006年1月至2016年5月北京大学第一医院确诊为宫颈腺癌并符合研究标准的住院患者99例,回顾性分析诊断途径、肿瘤分期及细胞学、病毒筛查情况等临床特点。结果:(1)近10年腺癌的发病比例呈现上升的趋势,不同时期宫颈腺癌临床分期差异有统计学意义(P<0.05)。(2)宫颈腺癌排在前3位的临床症状为阴道不规则流血、性生活后阴道流血、阴道分泌物异常,分别占37.37%(37例)、34.34%(34例)和8.08%(8例)。症状就诊组与体检就诊组比较后发现,宫颈腺癌临床分期、肿块直径、肌层浸润程度差异有统计学意义(P<0.05),而分化程度、病理类型、淋巴结转移、手术切缘等比较差异无统计学意义(P>0.05)。(3)宫颈腺癌细胞学筛查仍以鳞状细胞改变为主(42.19%),HPV检测中最常见型别为HPV18,占36.21%(21/58),17例(29.31%)HPV检测阴性。HPV阴性患者与阳性患者比较,宫颈腺癌肿块直径、肌层浸润及脉管癌栓差异有统计学意义(P<0.05),而发病年龄、病理类型、分化程度、临床分期、手术切缘及淋巴结转移比较差异无统计学意义(P>0.05)。结论:宫颈腺癌发生率逐年上升,但部分宫颈腺癌患者在筛查中表现为细胞学及HPV阴性,容易被漏诊,应提高对宫颈腺癌患者筛查的关注。
Objective：To evaluate the incidence trend and clinical characteristic changes of inpatients with cervical adenocarcinoma in the last decade. Methods ：A retrospective analysis was performed. 99 patients diagnosed with adenocarcinoma of cervix and hospitalized at Peking University First Hospital（PUFH） from January 2006 to May 2016 were included. Patients were divided into two groups according to the year and the results of screening. The clinical characteristics including basic information, diagnostic way and cancer stage were recorded and analysed. Results.①The incidence ratio of cervical adenocarcinoma had been significantly increased in the last decade,while clinical stage was statistically different. ②The top three symptoms of cervical adenocarcinoma were irregular vaginal bleeding,bleeding after intercourse, abnormal vaginal discharge, accounting for 37.37% ,34.34% and 8.08%, respectively. There were significant differences in the stage of cervical cancer and the diameter of the lesion（ P 〈 0.05） after the comparison between the symptomatic group and the asymptomatic group, but there were no differences in differentiation degree, pathological type, lymph node metastasis and resection margin. Cytological screening of cervical adenocarcinoma was still dominated by squamous cell changes （42. 19%）. HPV18 ranked first in HPV detection,accounting for 36.21% （21/58） ,however,29.31% cases were negative in HPV test. There was no significant difference in the age, pathological type, differentiation degree, resection margin and lymph node metastasis between HPV negative and positive patients with cervical adenocarcinoma （P 〉 0.05）. Conclusions： The incidence of cervical adenocarcinoma is increasing year by year. Some patients with cervical adenecarcinema have negative screening results for cytology and HPV, easy to be missed diagnosis, therefore,more attention should be put into the screening for cervical adenocarcinoma in order to find the cancer earlier.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2017年第11期838-843,共6页
Journal of Practical Obstetrics and Gynecology
关键词
宫颈腺癌
发病趋势
细胞学筛查
人乳头瘤病毒
Cervical adenocarcinoma
Incidence trend
Cytological screening
Human papilloma virus
