Analysis Of Pathological Features Of Cervical Cancer Before And After Menopause

Background and ObjectiveThe incidence of cervical cancer ranks first in female reproductive system malignancies.There are about 135,000 new cases of cervical cancer in China each year,accounting for 1/3 of the global number of cases.Epidemiological surveys show that women before and after menopause are at high risk for cervical cancer.At present,there is no research on the pathological characteristics of large samples of cervical cancer before and after menopause.Based on the large database platform for clinical diagnosis and treatment of cervical cancer in China,this study retrospectively analyzed the pathological features of cervical cancer before and after menopause in China for 13 years.Materials and methods ObjectsFrom the database,30665 cases of cervical malignant tumors confirmed by histopathology were retrieved,20 cases of age-deficient cases were deleted,and15215 cases of cervical cancer were isolated before and after menopause.The case data were obtained from clinical raw data,and the use of the data has been authorized by the organizer.MethodsData were collected and grouped according to age: <45 years old for young and middle-aged cervical cancer(middle-aged group,group A);45-60 years old for cervical cancer before and after menopause(peri-menopausal group);>60 years old for elderly Cervical cancer(elderly group,group E).Further grouping of cervical cancer before and after menopause: 45-49 years old group(group B);50-54 years old group(group C);55-60 years old group(group D).The peri-menopausal three groups were compared with the young and middle-aged groups and the elderly group for pathologically relevant indicators.Statistical methodsData analysis was performed using SPSS 21.0 statistical software.The measurement data is described as mean±standard deviation,and the count data is expressed by the number of cases and the percentage.The comparison between groups was performed by chi-square test or Fisher exact probability method,and?<0.05 was considered statistically significant.Results1.The number of cervical cancer cases and the distribution of urban and rural areas before and after menopause in different yearsThe number and proportion of cervical cancer in the Chinese mainland duringthe period from 2004 to 2016 showed an upward trend,from 283(44.1%)in 2004 to1179(55.6%)in 2016.Cervical cancer before and after menopause in all years was mostly in rural areas,with an annual proportion of more than 50%.2.Clinical stage and gross pathological features of cervical cancer before and after menopause2.1 Clinical stagingPeri-menopausal 45-49 years old group: IA1,IA2,IB1 ratio is lower than the young and middle-aged group,higher than the old group;IB2 stage is higher than the old group;IIA1,IIB-IIIB proportion is higher than the young and middle-aged group,lower than the elderly The proportion of IIA2 was higher than that of the young and middle-aged group;the proportion of IVB was lower than that of the old group(P<0.05).Peri-menopausal 50-54 years old group: IA1,IB1,IB2 phase ratio is lower than the young and middle-aged group,higher than the old-age group;IA2 phase ratio is lower than the young-age group;IIA1,IIB-IIIB,IVB ratio is higher than the young and middle-aged group,lower than the elderly group;the proportion of IIA2 was higher than that of the young and middle-aged group(P<0.05).peri-menopausal 55-60 years old group: IA1,IA2 phase ratio is lower than the young and middle-aged group;IB1,IB2 phase ratio is lower than the young and middle-aged group,higher than the old-age group;IIA1 phase ratio is higher than the young-age group;IIA2 phase ratio is higher than In the elderly group,the proportion of IIB-IIIB and IVB was higher than that of the young and middle-aged group,which was lower than that of the old group(P<0.05).There was no significant difference in the proportion of IVA in different age groups(P=0.158).2.2 Gross pathologyThe tumor size comparison showed that the tumor diameter of the 45-49 year old group and the 50-54 year old group was higher than that of the young andmiddle-aged group(P<0.05).The 55-60 year old group was lower than the young and middle-aged group(P<0.05);there was no significant difference between the two groups and the old group(P=0.722).The general type comparison showed that the peri-menopausal group of 45-49 years old: the proportion of exogenous type was higher than that of the old group(P<0.05).Peri-menopausal 50-54 years old group:the proportion of exogenous type was lower than that of middle-aged group,higher than that of old group;the proportion of ulcer type was higher than that of old group(P<0.05).Peri-menopausal 55-60 years old group: the proportion of exogenous type was lower than that of young and middle-aged group(P<0.05).The proportion of endogenous types in different age groups increased with the age of comparison between groups,the proportion increased(P<0.05).There was no significant difference in the proportion of cervical canal in different age groups(P=0.769).3.Histopathological features of cervical cancer before and after menopause3.1 Types of histologyPeri-menopausal 45-49 years old group: the proportion of squamous cell carcinoma was lower than that of the elderly group;the proportion of adenocarcinoma and adenosquamous carcinoma was higher than that of the elderly group(P<0.05).Peri-menopausal 50-54 years old group: the proportion of squamous cell carcinoma was higher than that of the young and middle-aged group,lower than the old group;the proportion of adenocarcinoma was lower than that of the young and middle-aged group;Peri-menopausal 55-60 years old group: the proportion of squamous cell carcinoma was higher than that of young and middle-aged group;the proportion of adenocarcinoma and adenosquamous carcinoma was lower than that of young and middle-aged group(P<0.05)There was no significant difference in the proportion of clear cell carcinoma in different age groups(P=0.328).The proportion of neuroendocrine small cell carcinoma in the three groups was lower than that in theyoung and middle-aged group(P<0.05),and there was no significant difference between the two groups(P>0.05).3.2 Histological gradingPeri-menopausal 45-49 years old group: the proportion of moderately differentiated cancer was lower than that of young and middle-aged group and older group;the proportion of poorly differentiated cancer was higher than that of young and middle-aged group and older group,and the proportion of undifferentiated cancer was lower than that of old group(P<0.05).Peri-menopausal 50-54 years old group:the proportion of well-differentiated cancer is lower than that of young and middle-aged group;the proportion of moderately differentiated cancer is lower than that of the old group;the proportion of poorly differentiated cancer is higher than that of the young and middle-aged group;the undifferentiated cancer is higher than the young and middle-aged group(P <0.05).Peri-menopausal 55-60 years old group: the proportion of well-differentiated cancer was lower than that of young and middle-aged group;the proportion of moderately differentiated cancer was higher than that of young and middle-aged group;the proportion of undifferentiated cancer was lower than that of old group(P<0.05).There was no significant difference in the proportion of high-grade differentiated cancer and moderately-differentiated carcinoma in different age groups(P>0.05).3.3 Cervical interstitial infiltration depthPeri-menopausal 45-49 years old group: the proportion of non-infiltration was lower than that of the young and middle-aged group,higher than the old group;the proportion of infiltration depth ?1/2 was higher than that of the old group;the ratio of infiltration depth >1/2 was lower than that of the old group(P<0.05).Peri-menopausal 50-54 years old group: the proportion of non-infiltration,infiltration depth ?1/2 is lower than that of young and middle-aged group,higher than the oldgroup;the ratio of infiltration depth >1/2 is higher than that of young and middle-aged group,lower than the old group(P<0.05).Peri-menopausal 55-60 years old group: the proportion of non-infiltration was lower than that of the young and middle-aged group;the proportion of infiltration depth ?1/2 was lower than that of the young and middle-aged group,higher than the old group;the infiltration depth >1/2 was higher than the young and middle-aged group.(P<0.05).The proportion of full-thickness infiltration in different age groups increased with the age of comparison between groups,and the proportion increased(P<0.05).3.4 Histopathological featuresThere was no significant difference in lymph node metastasis rate and parametrial metastasis rate between the perimenopausal group and the young and middle-aged group(P>0.05).The vascular infiltration rate showed that the proportion of menopausal 45-49 years old was higher than that of the young and middle-aged group,which was lower than that of the old group(P<0.05).The proportion of the50-54 year old group and the 55-60 year old group was higher than that of the young and middle-aged group(P<0.05).).The rate of nerve infiltration showed that the proportion of the three groups was higher than that of the young and middle-aged group(P<0.05),and there was no significant difference between the two groups(P>0.05).The infiltration rate of the uterus showed an increase in the age of the group and an increase in the proportion(P<0.05).Conclusions1.From 2004 to 2016,the number and proportion of cervical cancer in the mainland of China before and after menopause showed an upward trend,mostly in rural areas.2.The diameter of cervical cancer of 45-54 years old was larger than that of young and middle-aged groups,and the proportion of IIA2 and poorly differentiatedcancer was higher than that of the young and middle-aged groups.3.The vascular infiltration rate and nerve infiltration rate of cervical cancer before and after menopause were higher than those of young and middle-aged groups.4.There was no significant difference between the lymph node metastasis rate and the parametrial metastasis rate of cervical cancer before and after menopause and the young and middle-aged group and the elderly group.5.With the increase of age between groups,the incidence of stage IIB-IIIB cervical cancer,endogenous cervical cancer,cervical interstitial infiltration and uterine infiltration increased.