| Objective: To explore the change tendency of the onset age and the onset of related factors of cervical cancer patients, the clinical characteristic and the pathological features of patients with cervical cancer under 40 years old and over 40 years old,, and the clinical characteristic and the pathological features of asymptomatic patients with cervical cancer.To provide certain clinical basis for the develop and evaluation of cervical cancer prevention measures.Methods:A total of 861 patients with cervical cancer who were treated in gynaecology department of the first affiliated hospital of Wannan medical college from January 2004 to December 2013 were selected as the study objects,then using the retrospective analysis method, the onset age,the onset of related factors, the clinical characteristics and pathological features were analyzed.According to onset of the year was divided into 2004-2008 group( before 5 years group) and 2009-2013 group(after 5 years group);According to the onset age with patients was divided into under 40 years old group(the youth group) and over 40 years old group( the elder group);According to the onset of clinical symptoms are divided into asymptomatic group and symptomatic group.Results:( 1) The age of 861 patients with cervical cancer is from 20 to 83 years old. The averaged age was 46.72±3.12 years old,and the peak onset age focus on 41-45 years old;The Constituent ratio of the youth patients(≤40 years old) decreased from 30.83% in the year between 2004 to 2008 to 26.89% in the year between 2009 to 2013, but there had no statistically significant difference(P > 0.05);The patients with cervical cancer in the year between 2009 to 2013,the constituent ratio of farmer was 43.27% (269/621),the constituent ratio of the first marriage age in 20 and 22 years old was 37.36%(232/621), the constituent ratio of gravidity more than 3 times was 62.00%(385/621), the constituent ratio of parity more than 3 times was 31.01%(147/621),the constituent ratio less than group between 2004 to 2008,statistical significance was found compared with group between 2004 to 2008(P < 0.05).The patients with cervical cancer in the year between 2009 to 2013, The constituent ratio of workers or the individual was 20.77%(129/621), the constituent ratio of the clinical stage Ia was 12.89%(80/621),the constituent ratio more than group between 2004 to 2008,statistical significance was found compared with group between 2004 to 2008(P < 0.05).The patients with cervical cancer in the year between 2009 to 2013,the constituent ratio of rural area was 65.70%(408/621),the constituent ratio of the educational level lower than primary school was 51.69%(321/621),the constituent ratio of of patients with squamous cell carcinomas was 89.37%(555/621), but no statistical significance was found compared with group between 2004 to 2008(P > 0.05).HPV infection rate was 78.62%(118/150), HPV16 infection rate was 60%(90/150), HPV18 infection rate was 13.33%(20/150).(2) Group of younger than 40 years old of cervical cancer patients with clinical symptoms was mostly contact vaginal bleeding, accouting for 72.61%(175/241),the ratio less than group of older than 40 years old,there had statistically significant difference(P < 0.05);Cervical cancer in group of younger than 40 years, the constituent ratio of pathological type of non-squamous carcinoma was 10.37%(25/241), there was no statistically significant difference to compare with group of older than 40 years(P > 0.05);Cervical cancer in group of younger than 40 years, the constituent ratio of the clinical stage of stage Ia and Ib were 14.94%(36/241) and 44.40%(107/241), the constituent ratio more than group of older than 40 years old,there had statistically significant difference(P < 0.05).The constituent ratio of the clinical stage of stage III or IV ratio is 1.66%(4/241), the constituent ratio less than group of older than 40 years old,the difference had statistical significance(P < 0.05).(3) The averaged age in asymptomatic group of patients with cervical cancer was 42.65±2.73 years old, the symptomatic group was 46.87±0.71 years old, there had statistically significant difference between the two groups(P < 0.05). The constituent ratio of clinical stage Ia in asymptomatic group was 61.29%, the ratio in symptomatic group was only 9.04%, the differences between the two groups have statistically significance(P < 0.05);In asymptomatic group,The constituent ratio of without parametrial involvement was 100%(31/31),The constituent ratio of size of tumor less than 4 cm was 83.87%(26/31), The constituent ratio of deep cervical stromal invasion less than 1/2 was 83.87%(26/31), The constituent ratio of without lymph node metastases was 93.10%(27/29), The constituent ratio of without vascular involvement was 93.10%(27/29),there had statistically significant difference compared with symptomatic group(P < 0.05).The constituent ratio of pathological type of nonsquamous carcinoma in asymptomatic group was 9.68%(3/31), but there was no statistically significant difference compared with the symptomatic group(P > 0.05).Conclusion:(1) The age of main distribution of patients with cervical cancer focus on 41-45 years old, the incidence of youth patients with cervical cancer have no obvious change tendency, the incidence of workers or the individual and non-marriageable age of patients all have rise tendency; farmers, multiple pregnancy, prolific incidence of patients have a downward trend.The incidence of rural areas and the educational level lower than primary school in people are still without a downward trend. the incidence of clinical stage Ia with cervical cancer has a rising trend, but the incidence of the clinical stage of non-Ia stage and squamous carcinoma patients have no significant change tendency. HPV detection rate of cervical cancer is high.HPV16 is the most common subtype, and HPV18 followed.(2) Clinical symptoms in youth patients with cervical cancer is mainly contact vaginal bleeding, the middle-aged and old patients with clinical symptoms are vaginal bleeding and irregular vaginal bleeding.No difference between the youth and middle- aged and old patients with cervical cancer in pathological type.Youth clinical stage Ia and Ib with cervical cancer is more than middle-aged and old, but advanced cervical cancer(stage III or IV) relatively less middle-aged and old.(3) Age of symptomatic patients with cervical cancer is younger, clinical staging period is not lower, parametrial transfer rate is lower, the ratio of size of tumor less than 4 cm is higher, the ratio of deep cervical stromal invasion less than 1/2 is higher, the rate of lymphatic metastasis and vascular involvement were lower. |
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