Clinical Analysis Of 53 Young Women With Cervical Carcinoma

Object: Explore the high risk factors, clinical and pathological characteristics, treatment of young women (age≤35) with cerical cancer.Methods: By retrospectively analyzed 53 cases of young women (age≤35) with cervical cancer (the study group) and randomly selected 104 cases (age>35) of cervical cancer patients (the contrast group) in my hospital in recent 8 years:(1) The patient's age distribution and age composition situation.(2)The high risk factors of cervical cancer: age of marriage, pregnancy times, production times, occupation, smoking.(3) The clinical and pathological analysis: clinical manifestations, clinical stage,pathologic type, macroscopic type.(4) Treatment.Results: 1. The age distribution of patient: the study group is form 31 to 35 years, with an average age of 31.4 years old.The contrast group is form 46 to 50 years, with an average age of 47.4 years old. The total number of young women with cervical cancer accounted for all the cervical cancer patients at the same time in the hospital from 8.3% rose to 11.2% from 2003 until 2010,the incidence of young women with cervical cancer appears ascendant trend.2. High risk factors analysis: (1) Marriage age: there are 18 cases (33.96%) in the study group whose marriage age≤20 years old, and 18 cases (17.31%) in the contrast group whose marriage age≤20 years old. Comparing the two groups, P<0.05, the differences has statistically significant, it suggests that the young women with cervical cancer may be related with marriage at a young age. (2) Pregnant times: there are 21 cases (39.62%)in the study group whose pregnancy times≥3, and 56 cases (53.85%)in the contrast group whose pregnancy times≥3. Comparing the two groups ,P>0.05, the differences hasn't statistically significant, it suggests that the young women with cervical cancer may be not related with pregnancy times.(3) Production times:there are 5 cases (9.43%)in the study group whose production times≥3, and 19(18.27%) cases in the contrast group whose pregnancy times≥3. Comparing the two groups ,P>0.05, the differences hasn,t tatistically significant, it suggests that the young women with cervical cancer may be not related with production times .(4)Smoking: there are 16(30.19%) smokers in the study group, 16 (15.38%) smokers in the contrast group. Comparing the two groups, P<0.05, the differences has statistically significant, it suggests that the young women with cervical cancer may be related with smoking. (5)Occupation: there are 11(20.75%) cases are cadres or intellectuals in the study group, 13(24.53%) caeses are farmers, 29(54.72%) cases are individual and others. There are 15 (14.42%) cases are cadres or intellectuals in the old group, 30(28.85%) cases are farmers, 59(56.73%) cases are individual and others. Comparing the two groups , P>0.05, the differences hasn't statistically significant, it suggests that the young women with cervical cancer may be not related with occupation.3.Clinical manifestation: there are 30(56.60%) cases in the study group whose clinical manifestation is contact hemorrhages, 9 cases (16.98%) clinical manifestation is irregular bleeding. There are 34(32.69%) cases in the contrast group whose clinical manifestation is contact hemorrhages, 42 cases (40.38%) clinical manifestation is irregular bleeding. Comparing the two groups ,P<0.05, the differences has statistically significant, it suggests that the clinical manifestation of contact hemorrhages in the young women for cervical cancer diagnosis has more clinical significance, the clinical manifestations of irregular bleeding for elder patients diagnosis has more significance. 4.Clinical stage:The clinical stage is according to the FIGO 2009.There are 32(60.38%) cases is stage I in the study group, 20 cases(37.73%) is stage II, 1 (1.89%)cases is stage III,0 cases is stageIV.There are 45(43.27%)cases is stage I in the contrast group, 56 cases(53.85%) is stage II, 2(1.92%) cases is stage III,1(0.96%) cases is stageIV.Comparing the two groups in stage I ,P<0.05, the differences has statistically significant,it suggests that the stage may be earlier in the study group.5. Macroscopic type: there are 29 (54.72%) cases in the study group whose macroscopic type is exogenous type, 15(28.30%) cases of endogenous type, 6(11.32%) cases of ulcer type, 3(5.67%) cases of cervix tube type. There are 38 (36.54%) cases in the contrast group whose macroscopic type is exogenous type, 44(42.31%) cases of endogenous type, 15(14.42%) cases of ulcer type, 7(6.73%) cases of cervix tube type. Comparing the two groups with exogenous type, P<0.05, the differences has statistically significant, it suggests that the proportion of exogenous type in the study group higher than the contrast group.6. Pathologic type: there are 46 (86.79%) cases in the study group whose pathologic type is squamous cell carcinoma, 7(13.21%) cases of adenocarcinoma, 0 cases of adenosquamous carcinoma.There are 100(96.15%) cases in the contrast group whose pathologic type is squamous cell carcinoma, 3 (2.88%) cases of adenocarcinoma, 1 (0.96%) cases of adenosquamous carcinoma. Comparing the two groups whose pathologic type is squamous cell carcinoma, P<0.05, the differences has statistically significant, it suggests that the proportion squamous cell carcinoma in the contrast group is higher than the study group. Comparing the two groups whose pathologic type is adenocarcinoma, P<0.05, the differences has statistically significant, it suggests that the proportion of adenocarcinoma in the study group is higher than the contrast group.7. Treatment: all the 53 patients with cervical cancer, 44 cases accepted treatment of surgery, 5 cases accepted non-operative therapy, but 4 cases gave up treatment. All the patients treated by surgery are classified from stage Ia to IIa. 3 of Ia patients accepted total hysterectomy. 5 stage Ia, 12 stage Ib and 8 stage IIa accepted radical hysteretomy of cervical carcinoma (retained unilateral or bilateral adnexa),the rest (16 cases) accepted radical hysteretomy of cervical carcinoma. 22 cases of the patients treated by surgery (44 cases) accepted radiotherapy after surgery, 7 cases accepted chemotherapy after operation. 5 cases accepted non-operative therapy are stages IIb,3 cases adopted radio-chemotherapy, 2 cases accepted radiotherapy.Conclusion: The incidence of young women with cervical cancer appears ascendant trend; It is related with early age of marriage and smoking; Contact hemorrhages is the main clinical manifestations of young women with cerical cancer; The young women with cervical cancer mainly is in early stage, the pathological type mainly is squamous cell carcinoma . The main macroscopic type is exogenous type.