| Objective:To explore the shortcomings of the current clinical staging of cervical cancer,354 patients with early stage cervical cancer were retrospectively analyzed to compare the clinical staging and postoperative pathology.Methods:Among the retrospective analysis of 354 patients diagnosed with early cervical cancer in the Second Hospital of Shanxi Medical University from January 1,2004 to December 31,2014,there were 43 cases of IA stage(IA1 and IA2 stage),208 cases of IB1,and 103 cases of IIA1(Some cases were modified by staging).The preoperative clinical staging,pathological examination results,and postoperative pathological results were compared and analyzed according to the postoperative pathological results.Results:1.Among the 354 cases,the average age of the patients was 48.34 years old(range,24-70 years).72.3%(256/354)lived in rural areas,27.7%(98/354)in urban areas,96.6%(342/354)is married women;41.5%(147/354)of patients childbirth is more than 3 times;94.1%(333/354)is natural childbirth;5.9%(21/354)is cesarean section;and 1.1%(4/354)is sexually transmitted diseases(all syphilis).2.Abnormal cervical cytology results accounted for 75.4%(267/354).Positive HPV test results accounted for 80.8%(286/354).3.Surgical treatment alone accounted for 63.6%(225/354).Patients receiving additional chemotherapy after surgery accounted for 19.8%(70/354),patients receiving additional radiotherapy after surgery accounted for 5.6%(20/354),and patients receiving additional radiotherapy after surgery accounted for 11.0%(39/354).4.The FIGO staging(Some cases were modified by staging)before operation was significantly different from the results of pathological TNM after operation(P<0.001).The coincidence rate of preoperative and postoperative results was 48.0%,of which the coincidence rate of IA stage was 81.4%,which the highest among other stages;The compliance rate of IB1 period was the lowest compared with the other periods,which was 39.4%;the sub-period was 40.9%,and the over-high was 19.7%;the IIA1 coincidence rate was 51.5%,and the staged over-exposure accounted for 35.0%,which was significantly higher than the other periods;the sub-period was is 13.6%.The discrepancy rate of IA stage was the lowest,18.6%,compared with IB1 stage,IIA1 stage and IB1+ IIA1 stage,the difference was significant.There was a significant difference(P<0.001).5.The difference between preoperative pathological types of squamous cell carcinoma,adenocarcinoma,postoperative pathological types was statistically significant(P<0.001).The total coincidence rate of preoperative and postoperative pathological types was 96.6%(342/354),and the difference between preoperative and postoperative histological grades was statistically significant(P<0.001).The total coincidence rate of preoperative histological grades and postoperative histological grades was 95.3%(324/340),with the highest coincidence rate of grade II 97.2%(209/215).6.In early cervical cancer,the proportion of vascular invasion and lymph node metastasis in IB1 stage was higher than other stage.Lymph node metastasisin in IIA1 stage was higher than other stage.Compared with IA stage,the incidence of positive margin of vaginal incision,parauterine invasion and lymph node metastasis in IB1 stage was significantly different from that in clinical stage(P < 0.001).Compared with IIA1 stage,the possibility of positive margin of vaginal incision and vascular invasion in IB1 stage was significantly different from that in clinical stage(P < 0.001).The incidence ofvascular invasion in IB1 stage was 3.4 times higher than that of IIA1 stage.Conclusion:1.There was a significant difference between preoperative FIGO stage and postoperative pathological TNM stage.The clinical stage has some shortcomings.2.The coincidence rate of pathological type and histological grade before operation was higher than that after operation.3.Compared with stage IA and IIA1,the preoperative FIGO stage and postoperative pathological TNM stage of IB1 had the lowest coincidence rate. |
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