| Objective: Through the analysis of the case data of cervical cancer inpatients in Yan’an from 2011 to 2020,we can understand the characteristics and changes of cervical cancer inpatients in Yan’an,and provide theoretical basis for the propaganda and education,early screening,prevention,diagnosis and treatment of cervical cancer in Yan’an.Methods: Retrieve cervical cancer(C53)from the medical record browser,collect all newly diagnosed cervical cancer patients in the Affiliated Hospital of Yan’an University and the People’s Hospital of Yan’an City from January 2011 to December 2020.According to the inclusion and exclusion criteria,the final result is 1241 Patients with cervical cancer were included in this study.Retrospectively analyze the basic characteristics of newly diagnosed cervical cancer patients,the number of patients in each county in Yan’an,the development and changes of inpatients,clinical pathological data,and cervical cancer screening and other case data.All collected data are compiled by EXCEL and passed through the SPSS 25.0 statistical software Perform data analysis.Result: 1.Cervical cancer patients in Yan’an are mainly farmers,accounting for84.69%.The predominance of pregnancy and parity is ≥3 times.Irregular vaginal bleeding is the main cause of treatment,accounting for 51.81%.The reason for consultation is the comparison of menopausal conditions,which is irregular vaginal bleeding.It accounted for 72.53%,which became the main reason for postmenopausal women’s medical treatment;vaginal contact bleeding accounted for 40.81%,which became the main reason for non-menopausal women’s medical treatment.2.From 2011 to 2020,the top 5 patients with newly diagnosed cervical cancer admitted to the two tertiary hospitals in Yan’an City in various counties and districts are:Baota District,with 254 cases,accounting for 20.5%,and Ansai District,with 170 cases,accounting for 13.7%.There were 147 cases in the city,accounting for 11.8%,137 cases in Zhidan County,accounting for 11.0%,and 95 cases in Yichuan County,accounting for7.7%.3.In 10 years,the number of newly diagnosed cervical cancer hospitalized patients increased by 10.38% every year on average,and the number of cervical cancer hospitalized patients showed an overall upward trend over time.4.Among the 1241 patients,the minimum age of onset was 22 years old,the maximum age was 93 years old,the average age of onset was 51 ±17 years old,and the peak age group was 40-49 years old.the average age of onset increased from 49 ±16 years in 2011-2012 to 52 ±17 years in 2019-2020.the age range of 60-69 years old showed an upward trend,and the overall age of onset showed an upward trend.5.Cervical cancer staging,FIGO stage II,except for 2015-2016,ranked first;FIGO stage I ranked second.The proportion of FIGO stage I patients increased from 34.9% in2011-2012 to 44.2% in 2019-2020,and the proportion of FIGO stage II patients increased from 40.2% in 2011-2012 to 46.3% in 2019-2020,suggesting that FIGO stage I and Stage II patients have a trend of increasing year by year;the proportion of FIGO stage III and IV patients decreased from 23.0% in 2011-2012 to 7.6% in 2019-2020,suggesting that patients in FIGO stage III and IV have a decreasing trend year by year.6.Cervical cancer pathology type,SCC ranked first,but dropped from 98.6% in2011-2012 to 89.1% in 2019-2020;while AC rose from 1.0% in 2011-2012 to 6.8% in2019-2020,and other types increased from 0.4% in 2011-2012 4.1% by 2019-2020.The overall SCC showed a downward trend while the AC and other types showed an upward trend.7.The order of pathological differentiation of cervical cancer in different periods was moderate differentiation,high differentiation and low differentiation.The middle differentiation decreased from 51.7% in 2011-2012 to 44.2% in 2019-2020,while the low differentiation increased from 21.5% in 2011-2012 to 25.7% in 2019-2020,High differentiation shows an upward trend as a whole.8.There was a significant difference in different clinical stages between the physical examination group and the symptom group(P < 0.05).Among them,the FIGO stage Ⅰgroup was higher than the symptom group(78.79% vs 59.52%),and the Figo stage II group was higher than the physical examination group(38.89% vs 20.20%).There was a significant difference between the physical examination group and the symptom group in different degrees of differentiation(P < 0.05).The high differentiation in the physical examination group was higher than that in the symptom group(61.62% vs 20.83%),while the moderate differentiation(52.18% vs 32.32%)and low differentiation(26.99% vs6.06%)in the symptom group was higher than that in the physical examination group.There was a significant difference in the degree of myometrial infiltration between the physical examination group and the symptom group(P<0.05).The superficial muscle infiltration in the physical examination group was significantly higher than that in the symptom group(82.83% vs 46.63%),while the deep muscle layer and the whole layer in the symptom group were significantly higher than those in the physical examination group(40.28% vs 15.15%)and(13.09% vs 2.02%).There was a significant difference in lymph node metastasis between the physical examination group and the symptom group(P <0.05).There was no lymph node metastasis in the physical examination group,while 104 patients in the symptom group had lymph node metastasis(20.63%).There was no significant difference in other pathological types and vascular cancer thrombus among different reasons(P >0.05).9.Among 1241 patients with cervical cancer,281 patients underwent HPV and TCT examinations before diagnosis,186 cases were positive for both,accounting for 66.19%,12 cases were both negative,accounting for 4.27%,and either of them was positive There are269 cases,accounting for 95.73%.10.Among 1241 patients with cervical cancer,395 were tested for HPV before the diagnosis of cervical cancer,with a detection rate of 31.83%,including 31 cases of HPV negative,accounting for 7.85%,364 cases of positive,accounting for 92.15%,and 245 cases of HPV16,accounting for 67.31%,which was the main type of infection.The positive rates of HPV in the three clinicopathological types(SCC,AC and other types)were 93.03%,63.64% and 90.90%,respectively.When pairwise comparison was made,the positive rate of HPV in SCC was higher than that in AC(P < 0.0167).11.Among 1241 patients with cervical cancer,447 underwent TCT examination before diagnosis,with a detection rate of 36.02%.of which TCT was negative in 141 cases(31.54%)and positive in 306 cases(68.46%).There was no significant difference among different clinicopathological types(SCC,AC and other types).Conclusion: 1.The age of onset of cervical cancer in Yan’an City is generally on the rise,with a significant increase in the age group of 60-69 years.It is recommended to appropriately increase the age of cervical cancer screening in the “two cancers” general survey,which will help the early detection of cervical cancer and precancerous lesions.Intervention2.The incidence of cervical cancer in Yan’an City is increasing year by year.It is necessary to continue to strengthen the intensity of cervical cancer education and screening.It is recommended that postmenopausal women with irregular vaginal bleeding and nonmenopausal women with vaginal contact bleeding should be included as an aspect of cervical cancer publicity and education in this region.3.Cervical adeno-carcinoma cervix in Yan’an has an increasing trend year by year,and medical staff should pay more attention to cervical adenocarcinoma screening. |
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