| Objective: To analyze the medical records of cervical adenocarcinoma patients in the past five years retrospectively.Summarize and analyze the morbidity and clinical characteristics,in order to provide a certain clinical basis for the early diagnosis and treatment of cervical adenocarcinoma.Methods: By collecting all the cases of cervical adenocarcinoma from January 2014 to December 2018 at the First Affiliated Hospital of the Southern Anhui Medical College,118 cases that met the criteria were found to have been treated through the inclusion and exclusion criteria.The patient's age,pregnancy,birth time,clinical symptoms,gynecological examination,diagnosis method,cytological examination,HPV test,histopathological data,FIGO staging and other relevant information were recorded.Statistical analysis of data using SPSS 21.0 system.Results: The incidence of cervical adenocarcinoma has increased over the past five years,from 6.69 percent of cervical cancer in 2014 to 12.14 percent in 2018.The high incidence age of cervical adenocarcinoma is 46-50 years old.The average age of cervical adenocarcinoma patients is 49.81 ± 9.74 years old,and there is no obvious trend of rejuvenation.The gynecological examination of the cervix showed a erosive appearance,accounting for 50.83 %,of which 26 cases(22.03 %)were severe erosions,10 cases(8.47 %)were moderate erosions,and 18 cases(15.25 %)were mild erosions.The positive rate of TCT alone was 62.50 %(25/40),the positive rate of HPV alone was 75.00 %(36/48),and the combined detection rate of the two was 84.21 %(32/38).The diagnosis of adenocarcinoma in patients was confirmed by 69.49 %(82/118)of the first cervical biopsy under vaginal microscopy,and the rest was confirmed by multiple cervical biopsy,LEEP,and cervical tube scratching.In all patients,96 patients(81.36 %)were diagnosed with adenocarcinoma due to clinical symptoms,and 22 patients(18.64 %)were diagnosed with adenocarcinoma due to physical examination.The reasons for the first three visits were vaginal bleeding,contact bleeding,and physical examination.The clinical characteristics of the symptom patients and the physical examination patients were compared.The symptom group were more serious than the physical examination group in FIGO stage,the mass size,and the muscle infiltration,and the difference was statistically significant(P<0.05).There was no significant difference in lymph node metastasis and vascular infiltration between the two groups(P>0.05).The HPV negative group were more serious than HPV positive group in the swelling size and infiltration depth,and the difference was statistically significant(P<0.05),and there was no statistical difference in FIGO staging,vascular infiltration,lymph node metastasis(P>0.05).The immunohistochemical ER(94.23 %)and PR(96.15 %)were negative,and Ki-67(100 %),P16(90.38 %),P53(73.17 %),and CK7(94.29 %)were positive.Conclusion:(1)The incidence of cervical adenocarcinoma has been on the rise in the past five years.The average age of cervical adenocarcinoma patients is 49.81 ± 9.74 years old,and there is no obvious trend of rejuvenation.(2)HPV negative cervical adenocarcinoma patients than HPV positive patients with large masses,deep infiltration depth,should be paid attention to during clinical diagnosis and treatment.(3)The symptom group were more serious than the physical examination group in FIGO staging,mass size,and muscle infiltration.The physical examination could have discovered early cervical adenocarcinoma earlier.(4)The clinical symptoms of cervical adenocarcinoma lack specificity,the colposcopy image is not typical,and it is easy to miss diagnosis.Comprehensive utilization of various diagnostic methods such as TCT,HPV detection,cervical biopsy,LEEP,cervical scratch,and immunohistochemical examination can improve the early cervical adenocarcinoma detection rate. |
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