| Objective:The article collected 608 cases of the clinical data of cervical cancer patients in our hospital,and retrospectively analyzed their clinical and prognostic characteristics.Explored the related factors affecting the clinical and prognostic factors of cervical adenocarcinoma and cervical squamous cell carcinoma,so as to provide some reference of cervical adenocarcinoma and cervical squamous cell carcinoma in the clinical diagnosis and treatment.Methods:Clinical data of patients with cervical squamous cell carcinoma and adenocarcinoma confirmed by pathology from January 2009 to June 2020 were collected retrospectively and followed up by telephone and other means in the First Hospital of Jilin University.The clinical stage were Ⅰa-Ⅱa(FIGO 2009),including 529 patients with cervical squamous cell carcinoma,79 patients with cervical adenocarcinoma,and re-staging was conducted according to FIGO 2018.SPSS 26.0system was used for statistical analysis of data,Kaplan-Meier survival analysis and Cox proportional risk regression model were used to evaluate the prognostic factors.The statistical result P<0.05 was considered statistically significant.Results:1.The mean age at diagnosis of cervical cancer patients was 48.39±9.5 years old,and the overall age distribution was 21-76 years old.The mean age at diagnosis of cervical squamous cell carcinoma was 48.47±9.6 years,and the mean age at diagnosis of cervical adenocarcinoma was 47.89±9.2 years.There was no significant difference in the median age at diagnosis of squamous cell and adenocarcinoma of the cervix between the two groups(P>0.05).According to the staging criteria of FIGO 2009,in cervical cancer,there were 29 cases in stage IA1 and 5 cases in stage IA2,298 patients in stage IB1 and 77 patients in stage IB2,82 patients in stage IIA1 and 117 patients in stage IIA2.According to the staging criteria of FIGO 2018,in cervical cancer,there were 29 cases in stage IA1 and 5 cases in stage IA2,103 cases in stage IB1,169 cases in stage IB2,and 53 cases in stage IB3,54 patients in stage IIA1 and77 patients in stage IIA2,114 patients in stage IIIc1 p and 4 patients in stage IIIc2 p.2.The clinical manifestations of patients in both groups were contact bleeding,irregular vaginal bleeding,abdominal pain or low back pain,vaginal discharge,and asymptomatic.There was no statistical significance in clinical manifestations and macroscopic view of cervix between 2 groups(P>0.05).The difference of preoperative and postoperative pathology in the cervical adenocarcinoma group was higher than that in the cervical squamous cell carcinoma group,and the difference between the two groups was statistically significant(P<0.05).3.There were statistically significant differences in tumor diameter and degree of pathological differentiation between cervical squamous cell carcinoma and adenocarcinoma(P<0.05).Among all HPV-positive patients,the HPV-positive rate was 95.3%(428/449)in cervical squamous cell carcinoma and 79.7%(51/64)in cervical adenocarcinoma,and the difference was significant between the two groups(P<0.001).Among all patients with positive TCT,the positive rate of TCT in cervical squamous cell carcinoma was 89.0%(105/118)and that in cervical adenocarcinoma was 48.8%(21/43),and the differences between the two groups were significant(P<0.001).4.The 1-year,3-year and 5-year survival rates of patients with cervical cancer were 99.4%,91.6% and 85.8%,respectively.The 1-year,3-year and 5-year survival rates of patients with cervical adenocarcinoma were 100.0%,86.2% and 77.0%,respectively,and the 1-year,3-year and 5-year survival rates of patients with cervical squamous cell carcinoma were 99.3%,91.7% and 86.4%,respectively.Kaplan-Meier survival analysis(Log Rank comparison)showed no statistically significant difference in survival rates between squamous cell carcinoma and adenocarcinoma(P>0.05).5.Tumor diameter,interstitial invasion depth,lymph node metastasis,clinical stage(FIGO 2009)and clinical stage(FIGO 2018),vascular invasion,nerve invasion were related factors affecting the prognosis of cervical cancer(P<0.05).Pathological type and clinical stage(FIGO 2018)were independent predictors of prognosis in patients with cervical cancer(P<0.05).6.Tumor diameter,interstitial invasion depth,lymph node metastasis,clinical stage(FIGO 2009),clinical stage(FIGO 2018)and nerve invasion were related factors affecting the prognosis of cervical squamous cell carcinoma(P<0.05).Clinical stage(FIGO 2018)was independent prognostic factors for patients with cervical squamous cell carcinoma(P<0.05).7.Tumor diameter,interstitial invasion depth,lymph node metastasis,clinical stage(FIGO 2018)and vascular invasion were related factors affecting the prognosis of cervical adenocarcinoma(P<0.05).Tumor diameter and vascular invasion were independent prognostic factors of cervical adenocarcinoma(P<0.05).Conclusion:1.The age of diagnosis of cervical cancer was mainly 42-55 years old,and there was no significant difference between the age of diagnosis of cervical squamous cell carcinoma and cervical adenocarcinoma.2.The main clinical manifestations of cervical cancer are vaginal bleeding and vaginal drainage,and there was no statistical significance in the clinical manifestations and macroscopic view of cervix between the two groups(P>0.05).The preoperative and postoperative pathological inconsistencies of the cervical adenocarcinoma group were higher than that of the cervical squamous cell carcinoma group.Preoperative differential diagnosis of cervical adenocarcinoma should be strengthened.3.The 5-year survival rate was 85.8% for cervical cancer,77.0% for cervical adenocarcinoma and 86.4% for cervical squamous cell carcinoma.Clinical stage(FIGO 2018)was independent prognostic factors for patients with cervical squamous cell carcinoma.Tumor diameter and vascular infiltration are independent prognostic factors in patients with cervical adenocarcinoma.There was no significant difference in prognosis and survival time between cervical adenocarcinoma and squamous cell carcinoma of stage Ⅰa-Ⅱa.Patients with adverse prognostic factors should be closely followed up. |
