Unexpectedly Discovered Clinical Analysis Of 127 Cases Of Cervical Cancer

Objective:Analysis of the causes of unexpected discovery of cervical cancer(UDCC),how to avoid UDCC occurrence,and the comparison of the occurrence of complications and survival rates of the two complementary treatments for the selection of future UDCC supplementary treatment Clinical basis.Methods:Retrospective analysis of the initial operation of patients with cervical cancer(including 31 referrals from outside hospitals,24.40%)who were found in specimens after undergoing total hysterectomy(laparoscopic,laparotomy,and vaginal)from2010 to 2016 at Shanxi Cancer Hospital Signs,preoperative cervical screening,postoperative pathological results,whether to receive supplementary treatment,supplementary treatment,and survival rate.Results:1.From 2010 to 2016,10333 cases of cervical cancer were treated surgically.Among them,127 cases of cervical cancer were discovered accidentally(including 31 referrals from external hospitals,24.40%),accounting for 1.22%.2.Of the 127 cases,87 cases(68.50%)were not screened for cervical cancer screening.The false negative rate of TCT and the missed rate of biopsy were 13.11%and 1.72%,respectively.3.The first surgical indications were cervical intraepithelial neoplasia(114 cases,grade I-III(89.76%)),uterine fibroids(8 cases)(6.29%),uterine empyema(2 cases,1.57%),and endometrial carcinoma(1 case).0.78%),1 case of ovarian cyst(0.78%),1 case of adenomyosis(0.78%).4.Of the 127 patients,125 patients were followed up,of whom 6 died and the mortality rate was 4.80%.The 3-year survival rate of patients with pathological type squamous cell carcinoma was higher than that of non-squamous cell carcinoma patients(P<0.05),but there was no significant difference between the 5-year survival rate and overall survival rate(P>0.05).5.In UDCC patients,according to FIGO stage IA1 81 cases(63.77%),IA2 stage40 cases(31.49%),IB1 stage 5 cases(3.93%),IV stage 1 case(0.78%,postoperative disease examination ovarian The surface shows cancerous tissue).Completed follow-up of 125 patients,125 of 71 patients(43.20%)received no supplementary treatment,4 patients received secondary surgery(3.20%),52 patients received radiotherapy(41.60%),3 years of secondary surgery and radiotherapy survived.The rate and 5-year survival rate were not statistically different(P>0.05).(Two patients who underwent the second operation had secondary surgery for preservation of ovarian function.Two cases of pathological return were lymph node metastasis and high risk factors.Radiotherapy was given after the second operation)6.The analysis of the metastasis and complications of secondary supplementation and supplemental radiotherapy found that there were 5 cases of complications of complementary radiotherapy and 1 case of abdominal wall metastasis.No metastases and complications occurred in the secondary surgeries.No statistical significance,P all>0.05.The exception was not related to the relatively small number of secondary supplementation procedures and the relatively small age of patients selected for secondary supplementation.7.The ages of follow-up patients were 32-75 years old and the average age was52.8 years.There were 24 patients <45 years old and 101 patients?45 years old.Riskfactors for survival of UDCC patients were age affected by regression analysis of COX risk..The lower the age,the higher the mortality rate and the lower the survival rate.(P<0.05)Conclusions:Before cervical excision of gynecological benign lesions should be performed cervical cytology and HPV-DNA detection,in strict accordance with the "three steps" for screening to avoid the occurrence of UDCC.Colposcopy biopsy should pay attention to the scope of sampling and sampling depth,in order to shift the scale of the junction of patients with cervical endocervical,cervical biopsy must be scraped after the neck tube to prevent missed examination.In the case of high-grade CIN patients,diagnostic conization should be used as the preferred treatment.For young UDCC patients with retained ovarian function and no risk factors,secondary supplementation surgery may be considered;for young UDCC patients with retained ovarian function and high risk factors,laparoscopic surgery for bilateral ovarian suspension can be considered.To add chemotherapy;for older UDCC patients who do not retain ovarian function and have high-risk factors,we can consider direct chemoradiotherapy.