Analysis Of Prognosis Factors In Young Patients With Cervical Cancer

Objective:Cervical cancer is the most common cancer among womenworldwide. The incidence of cervical cancer is the third in developedcountries,and the first in developing countries.As cervical cancer screeningextensively in recent years,the incidence and mortality of cervical cancer havebeen significantly reduced,but The prevalence trend of the cervical cancertends to be younger.Compare with elderly cervical cancer patients,youngpatients with cervical cancer has a unique clinical characteristics andpathological features. Now review the clinical data of cervical cancer patientsin the Fourth Hospital of Hebei Medical University in the past four years,analyse the differences between young cervical cancer patients and elderlypatients,and study of pathological factors and prognosis of young women withcervical.Young patients with cervical cancer should be paid more attention,andgain early diagnosis and treatment to reduce the incidence and mortality ofcervical cancer.Methods:Select the clinical data of cervical cancer treated in the FourthHospital of Hebei Medical University from July25,2008to December16,2011.And all of the clinical datas of postoperative pathologic have beenconfirmed for cervical cancer.124patients (≤40years) were selected as studygroup and124patients were selected randomly from patients (>40years) ascontrol group, clinical manifestations,cervical morphology,clinicalstages,pathological types, histological grades,lymph node metastasis rate andvascular tumor emboli were compared between the two groups,and study ofpathological factors and prognosis of young women with cervical.SPSS18.0software package was used to process statistical data. Adopt χ2test to analyse the enumeration data and the differences between the studygroup and control group. The survival rates were calculated by Kaplan-Meier method.Univariate analysis was estimated by log-rank test. Adopt Coxproportional hazards model for multivariate regression analysis.Statisticaldifferences were indicated by P<0.05.Results:1Young cervical cancer patients and elderly patients with cervical cancer inthe place of residence was no significant difference (P>0.05),and they were67.7%,75.0%.2Young cervical cancer patients and elderly patients with motherhood morethan three times were58.1%,75.8%,and patients with parity more than threetimes were9.7%和38.7%.The differences were statistically significant (P<0.05).History of abortion in young group and elderly group were70.2%and66.9%, and they have no significant difference (P>0.05).3Young cervical cancer patients had unique clinical manifestations, mainly ascontact vaginal bleeding(67.7%) and cervical tumor(81.5%), there weredifferences in elderly patients with cervical cancer(41.9%,66.1%), and thedifference was statistically significant (P <0.05).4Cancer history of the families of the two groups accounts for14.5%and8.1%. It was no significant difference (P>0.05).5Young patients with cervical cancer were mainly on earlier clinical stage,compared with elderly patients,the difference was statistically significant (P<0.05).They were79.8%and62.9%.6The lymph node metastasis rate of young cervical cancer patients andelderly patients were26.6%,16.1%.And young patients have a higher rate. Thedifference was statistically significant (P <0.05).7Approximately25.0%of young cervical cancer patients had vascular tumoremboli,and7.3%of elderly patients with cervical cancer had vascular tumoremboli.The difference was statistically significant (P <0.05).8Young group and older group in the pathological type, tumor size,parametrial metastasis, histological grade,myometrial invasion and vaginalstump invasion had no significant difference (P>0.05).9Vascular invasion, myometrial invasion, atrophy of the vaginal stump were significantly associated with lymph node metastasis in young women withcervical cancer.Young cervical cancer with vascular invasion, deepmyometrial invasion or vaginal stump invasion had a high rate of lymph nodemetastasis,and the difference was statistically significant (P <0.05).10Univariate analysis: lymph node metastasis, vascular invasion, parametrialinvasion and vaginal stump lesions were significantly associated with youngpatients with cervical cancer(P <0.05).The prognosis of young patients withlymph node metastasis, vascular invasion or parametrial invasion werepoor.Multivariate analysis:pathological type, tumor size, clinical stage,histological grade, myometrial invasion,lymph node metastasis, vascularinvasion, parametrial invasion and vaginal stump lesions were not independentrisk factors.Conclusions:1The prevalence trend of the cervical cancer tends to be younger.It may bedue to the infection of HPV,first sexual intercourse age prematurely,sexualdisorders,long-term oral contraceptives and others.2Young patients with cervical cancer has a unique clinical manifestations,and contact bleeding and cervical tumor is the main symptoms.But there aresome young patients with cervical cancer that clinical symptoms and signs isnot obvious, so attention should be paid.3Compared with the elderly patients with cervical cancer, the pathologicalfeatures of young patients with cervical cancer is mainly as earlier clinicalstage, a higher rate of lymph node metastasis and vascular invasion.4Vascular invasion, myometrial invasion, atrophy of the vaginal stump aresignificantly associated with lymph node metastasis in young women withcervical cancer.5Lymph node metastasis, vascular invasion, parametrial invasion and vaginalstump lesions are significantly associated with young patients with cervicalcancer.Pathological type, tumor size, clinical stage, histological grade,myometrial invasion, lymph node metastasis, vascular invasion, parametrialinvasion and vaginal stump lesions are not independent risk factors in young patients with cervical cancer.6Strengthen women health and hygiene education,and popularize the cervicalcancer screening for early diagnosis and treatment of cervical cancer.It hasimportant clinical significance.7The treatment of cervical cancer need to follow the standardized,individualized and humane principles to prolong the lives of patients andimprove the quality of life.