Analysis Of Clinical Course And Prognostic Factors Of Cervical Cancer In Women Under 35 Years Old

Objective: To analyse the etiology, clinical and pathological features, prognostic factors and the quality of life(QOL) of cervical cancer in women under 35 years oldMethods: 1 In the 1999-2008 admission Tumor Hospital of Harbin and Fourth Hospital of Harbin Medical University (hereinafter referred to as: the two hospitals) age≤35 years of age were 58 young patients with /269 patients, >35 patients in the clinical date of elderly cases of cervical cancer by case-case control study of young cervical cancer incidence and clinicopathologic fators.2 The clinicopathologic records of 115 patients with cervical cancer of stageⅠ-Ⅱa who underwent radical hysterectomy and pelvic lymphadenectomy were retrospectively analyzed,and the prognostic factors were explored by univariate and multivariate methods. Independent prognostic factors were identified by COX proportional hazards regression model.3 The Chinese FACT-CX questionnaire were self-reported by the 63 patients treated by surgery. The influential factors of the quality of life(QOL) were explored by multilple linear regression.Result: 1 Clinicopathological features1.1 Disease factors: Patients with cervical cancer mainly concentrated in the towns and villages, first sex mainly focus on 21 years of age. One young group approach to the tools of contraception and contraceptive pill proportion of the majority. The proportion of those who have multiple sexual partners than in the older group, but pregnancy is less than the number of middle-aged group.1.2 Clinical stage: Younger group includes 10 cases of carcinoma in situ (17.24%, 10/58),31 cases of stageⅠ(53.45%,31/58), and the both accounted for 70.69%, Middle-aged group includes 20 cases of carcinoma in situ (7.43%, 20/269), 89 case of stageⅠ(33.08%,89/269), and the both accounted for 40.51%. Clinical stage of the two groups differ in the overall distribution is different(P<0.05).1.3 Clinical manifestations: Mainly for the younger group contact vaginal bleeding in 37 cases (63.79%, 37/58), Middle-aged group, irregular bleeding or postmenopausal bleeding accounted for 76 cases (28.25%, 76/269). Difference between the two groups was statistically significant(P<0.05).1.4 Vascular invasion: 46 cases were detected in the young group, which found that intravenous tumor thrombus in 16 patients (34.78%, 16/46), 200 cases were detected in the young group, which found that intravenous tumor thrombus in 40 patients(20.00%,40/200). Overall positive rate of two groups of thrombosis was significantly different.2 Clinicopathologic factors affecting survival2.1 Two groups stageⅠ-Ⅱa radical surgery of cervical cancer 5-year cumulative survival rate of 82.95%, The younger group and older group of 5-year cumulative survival rates were 70.27% and 89.31%, The difference was statistically significant (P = 0.0386).2.2 Factors affecting the prognosis of cervical cancer. COX multivariate analysis showed that the degree of cervical myometrial invasion, vascular conditions and pelvic lymph node metastases involving the number of the younger group and older group of common prognostic factors, but factors affecting the prognosis of cervical cancer are young and tumor size.2.3 Factors affecting survival rate. Cervical pathology suggestive of myometrial invasion≥1 / 2, with tumor thrombus involving the lymphatic vessels, pelvic lymph node metastasis and vaginal cancer metastasis resection as risk factors. Of which there were≥2 high-risk factors, postoperative radiotherapy or chemotherapy with no treatment survival rates were 83.33% and 16.67%, respectively, the difference was significant (P <0.05).3 quality of life and factorsThe younger group and older group, the quality of life scores between the two groups showed no significant difference (P = 0.277), but age, residence, ovarian transposition, education as the main factors affecting the quality of life.Conclusion: 1 Early clinical stage was the main characteristic in young patients with cervical carcinoma;2 In comparison to the older patients with cervical cancer, though the quality of life the same,the prognosis was poor in young patients,maybe it was related to higher percentage of the lymph vascular involvement and pelvic lymph node metastasisn;3 Adjuvant treatment may be helpful for patients with 2 or more risk factors after radical surgery,but not for improveing quality of life;4 We should emphasize sexual education and cervical screening to young women.