| Objective:In this paper,the general clinical data,pathological data and survival curve of young patients with cervical cancer(≤35 years old)were retrospectively analyzed to explore the clinical characteristics,postoperative recurrence and prognostic factors.Methods:A total of 2742 cervical cancer patients were selected from The Affiliated Hospital of Qingdao University from January 2004 to March 2019,including 243young cervical cancer patients≤35 years old as the research group,and 250 first and second cervical cancer patients>35 years old who were admitted to hospital each month were randomly selected as the control group.The clinicopathological data of the two groups were compared,and the survival curves of the two groups were analyzed.The general pathological data of young cervical cancer patients with postoperative recurrence(17 cases)and non-recurrence(164 cases)were compared,and the prognostic data were analyzed by univariate and multivariate analysis.Results:1.Married young patients with cervical cancer,menarche age earlier than the control group,the pregnant,production time is less than the control group,preoperative adjuvant treatment is lower than the control group,keep ovarian probability is higher than the control group,nerve invasion probability is greater than the control group,the difference was statistically significant(P<0.05),two groups of patients with cervical cancer in hierarchical organization,LVSI,beside the palace and transfer,etc.No significant differences.2.In comparison of clinical features of the first episode between young patients with cervical cancer and patients with cervical cancer>35 years old,the proportion of contact vaginal bleeding in young patients with cervical cancer was higher than that in the elderly,and the proportion of irregular vaginal bleeding was lower than that in the elderly,with statistical significance(P<0.05).Contact vaginal bleeding is the first clinical symptom in most young patients with cervical cancer.There was no significant difference between the two groups in physical examination findings,abnormal vaginal secretions,vaginal discharge,low back pain or abdominal pain,reduced menstrual volume and other aspects(P>0.05).3.By the end of follow-up,17 patients(9.1%)in the study group died,while 18patients(10.3%)in the control group died,there was no significant difference between the two groups(χ~2=0.148,P=0.701).Kaplan-meier survival was estimated to be 157.37±4.32 months in the study group and 167.32±4.65 months in the control group,respectively.Log-rank testχ~2=0.031,P=0.859 showed no significant difference between the two survival curves.The 5-year(60-month)survival rate of the study group and the control group was 88%and 86%,respectively,with no significant difference(χ~2=0.177,P=0.674).4.There were statistically significant differences in FIGO stage,histological grade,depth of cervical invasion,lymphatic vascular invasion and pelvic lymph node metastasis between recurrent and non-recurrent patients in the study group(P<0.05).In the control group,there were statistically significant differences in FIGO stage,surgical approach,histological grade,depth of cervical invasion,nerve invasion,lymphatic vascular invasion,pelvic lymph node metastasis,etc.(P<0.05).5.Multivariate analysis showed that FIGO stage,LVSI and pelvic lymph node metastasis were independent risk factors affecting the prognosis of young cervical cancer patients(P<0.05).Patients with early FIGO stage,no LVSI and pelvic lymph node metastasis had a good prognosis.Histological grade,depth of cervical invasion and LVSI were independent risk factors affecting the prognosis of elderly cervical cancer(P<0.05).Patients with low histological grade,shallow cervical invasion and no LVSI had better prognosis.Conclusion:1.The incidence of nerve infiltration in young cervical cancer patients is higher than that in elderly cervical cancer patients,and there is no significant specificity in tissue grade,LVSI,paracytouterine metastasis and other aspects.There was no significant difference in 5-year survival rate between the two groups.2.Laparoscopic surgery with nerve infiltration had no significant effect on the recurrence rate of young cervical cancer patients,while the recurrence rate of elderly cervical cancer patients was significantly increased.The recurrence rate of cervical cancer patients in both groups was significantly increased when the tumor stage was late,tissue differentiation was poor,cervical infiltration was deep,LVSI was present,pelvic lymph node metastasis was present.3.Late tumor stage,LVSI and pelvic lymph node metastasis were independent risk factors affecting the prognosis of young cervical cancer,while poor tumor differentiation,deep cervical invasion and LVSI were independent risk factors affecting the prognosis of elderly cervical cancer. |
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