Meta Analysis Of Clinical Features And Prognosis Of Young Patients With Cervical Cancer

Objective To investigate the young cervical cancer patients.Methods To retrieve Pubmed, Ovid medline, CNKI full-text database, VIP database, and collect relevant case-control study of literature about aged35years or younger and aged over35years patients with cervical cancer, according to predetermined standards. Then, we evaluated the quality of included studies, and extracted the corresponding indicators to complete the Meta analysis.Review Mananger5.2software was used for Meta analysis,heterogeneity test set as P>0.05.Result1. To assess the incidence of early-stage cervical cancer between two groupsTotal8documents cases were selected,of which a total of1525cases young group,the elderly group group in4547cases.Homogeneity test of clinical data, χ2=55.25, df=9, P<0.05,because there is heterogeneity in documents,the result adopt random-effect model.The result shows:There was statistical significance in the incidence of early-stage cervical cancer,and the young is larger than the elderly,(Z=3.41, OR=3.41,95%CI=1.40～3.48, P<0.05).(see figure1).2.To assess the incidence of non-squamous cervical cancerTotal16documents cases were selected,of which a total of2540cases young group,the elderly group group in11075cases.Homogeneity test of clinical data, χ2=57.92, df=15, P<0.05,because there is heterogeneity in documents,the result adopt random-effect model.The result shows:There was statistical significance in the incidence of non-squamous cervical cancer,and the young is larger than the elderly (Z=2.37, OR=1.46,95%CI=1.07～2.00, P<0.05).(see figure3)3.To assess the incidence of histopathological G3cervical cancerTotal8documents cases were selected,of which a total of484cases young group,the elderly group group in1507cases.Homogeneity test of clinical data, χ2=10.11, df=7, P>0.05,because there is not heterogeneity in documents,the result adopt fixed-effect model.The result shows:There was statistical significance in the incidence of histopathological G3cervical cancer,and the young is larger than the elderly (Z=2.01, OR=1.37,95%CI=1.01～1.87, P<0.05).(see figure5)4.To assess the incidence of tumor size>4cm cervical cancerTotal3documents cases were selected,of which a total of96cases young group,the elderly group group in611cases.Homogeneity test of clinical data, χ2=0.12, df=2, P>0.05,because there is not heterogeneity in documents,the result adopt fixed-effect model.The result shows:There was not statistical significance in the incidence of tumor size>4cm cervical cancer (Z=1.71, OR=1.49,95%CI=0.94-2.36, P>0.05).(see figure7)5.To assess the incidence of depth of stromal invasion (DSI)≥1/2Total5documents cases were selected,of which a total of984cases young group,the elderly group group in2556cases.Homogeneity test of clinical data, χ2=7.12, df=4, P>0.05,because there is not heterogeneity in documents,the result adopt fixed-effect model.The result shows:There was not statistical significance in the incidence of depth of stromal invasion (DSI)≥1/2cervical cancer(Z=1.12, OR=0.91,95%CI=0.78～1.07, P>0.05).(see figure9)6.To assess the incidence of lymph vascular space invasion (LVSI)≥1/2 Total5documents cases were selected,of which a total of984cases young group,the elderly group group in2668cases.Homogeneity test of clinical data, χ2=6.91,df=4, P>0.05,because there is not heterogeneity in documents,the result adopt fixed-effect model.The result shows:There was not statistical significance in the incidence of depth of lymph vascular space invasion (LVSI)≥1/2cervical cancer (Z=0.81, OR=0.94,95%CI=0.80～1.10, P>0.05).(see figure11)7.To assess the incidence of lymph nodes (LN) metastasesTotal8documents cases were selected,of which a total of1105cases young group,the elderly group group in2876cases.Homogeneity test of clinical data, χ2=25.05, df=7, P<0.05,because there is heterogeneity in documents,the result adopt random-effect model.The result shows:There was statistical significance in the incidence of lymph nodes (LN) metastases,and the young is larger than the elderly,(Z=1.61, OR=1.67,95%CI=1.14-2.46, P<0.05).(see figure13)8.To assess the survival rates of two groupsTotal5documents cases were selected,of which a total of1038cases young group/the elderly group group in2093cases.Homogeneity test of clinical data, χ2=19.65, df=4, P<0.05,because there is heterogeneity in documents,the result adopt random-effect model.The result shows:There was statistical significance in the survival rates of two groups,and the young is larger than the elderly (Z=1.61, OR=1.67,95%CI=1.14～2.46, P<0.05).(seefigure15)Conclusion1.There was statistical significance between tow groups in FIGO stage,histologic types, lymph nodes metastases and survival rates.And the young group aged under35is given priority to the early-stage non-squamous cancer.The incidence of lymph nodes metastases and histological G3is larger than the elderly.So the survival rates is lower than the elderly.There is not statistical significance in depth of stromal invasion, lymph vascular space invasion, and tumor size.2. We should strengthen the cervical cancer prevention knowledge and the promotion of screening.Meantime do early diagnosis and early treatment.