本文選題：宮頸腺癌 + 發(fā)病趨勢�。� 參考：《實用婦產(chǎn)科雜志》2017年11期

【摘要】：目的:探討10年來宮頸腺癌住院患者發(fā)病趨勢及臨床特點。方法:2006年1月至2016年5月北京大學第一醫(yī)院確診為宮頸腺癌并符合研究標準的住院患者99例,回顧性分析診斷途徑、腫瘤分期及細胞學、病毒篩查情況等臨床特點。結(jié)果:(1)近10年腺癌的發(fā)病比例呈現(xiàn)上升的趨勢,不同時期宮頸腺癌臨床分期差異有統(tǒng)計學意義(P0.05)。(2)宮頸腺癌排在前3位的臨床癥狀為陰道不規(guī)則流血、性生活后陰道流血、陰道分泌物異常,分別占37.37%(37例)、34.34%(34例)和8.08%(8例)。癥狀就診組與體檢就診組比較后發(fā)現(xiàn),宮頸腺癌臨床分期、腫塊直徑、肌層浸潤程度差異有統(tǒng)計學意義(P0.05),而分化程度、病理類型、淋巴結(jié)轉(zhuǎn)移、手術(shù)切緣等比較差異無統(tǒng)計學意義(P0.05)。(3)宮頸腺癌細胞學篩查仍以鱗狀細胞改變?yōu)橹?42.19%),HPV檢測中最常見型別為HPV18,占36.21%(21/58),17例(29.31%)HPV檢測陰性。HPV陰性患者與陽性患者比較,宮頸腺癌腫塊直徑、肌層浸潤及脈管癌栓差異有統(tǒng)計學意義(P0.05),而發(fā)病年齡、病理類型、分化程度、臨床分期、手術(shù)切緣及淋巴結(jié)轉(zhuǎn)移比較差異無統(tǒng)計學意義(P0.05)。結(jié)論:宮頸腺癌發(fā)生率逐年上升,但部分宮頸腺癌患者在篩查中表現(xiàn)為細胞學及HPV陰性,容易被漏診,應提高對宮頸腺癌患者篩查的關注。
[Abstract]:Objective: to investigate the incidence trend and clinical characteristics of cervical adenocarcinoma inpatients in recent 10 years. Methods: from January 2006 to May 2016, 99 patients with cervical adenocarcinoma diagnosed in the first Hospital of Peking University who met the research criteria were retrospectively analyzed for the clinical features of diagnosis, tumor staging, cytology, virus screening and so on. Results (1) the incidence rate of adenocarcinoma of cervix increased in the last 10 years, and there were significant differences in clinical stages of cervical adenocarcinoma in different periods (P 0.05). 2) the first three clinical symptoms of cervical adenocarcinoma were irregular vaginal bleeding and vaginal bleeding after sexual life. The vaginal discharge was abnormal in 37.37 cases (34.34 cases) and 8.08 cases in 8 cases. The clinical stage of cervical adenocarcinoma, the diameter of mass and the degree of myometrium infiltration were significantly different between the symptom group and the physical examination group (P 0.05), but the differentiation degree, pathological type, lymph node metastasis were significantly different. There was no statistically significant difference in surgical margin between the two groups. (P0.05) the cytological screening of cervical adenocarcinoma was still dominated by squamous cell changes. The most common type of HPV detection was HPV18, accounting for 36.21% of 21% of HPV18, accounting for 17 cases of HPV-negative or HPV-negative in 17 patients with negative or negative HPV testing. The diameter of cervical adenocarcinoma masses was higher than that of the controls. There were significant differences in myometrial invasion and vascular tumor thrombus (P 0.05), but there was no significant difference in age, pathological type, differentiation, clinical stage, surgical margin and lymph node metastasis. Conclusion: the incidence of cervical adenocarcinoma is increasing year by year, but some of the cervical adenocarcinoma patients are cytological and HPV negative, which is easy to be missed, so we should pay more attention to the screening of cervical adenocarcinoma patients.
【作者單位】： 北京大學第一醫(yī)院;
【分類號】：R737.33
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本文編號：1870610