宫颈非鳞状细胞恶性肿瘤35例临床病例分析

发布时间：2018-07-16 23:03

【摘要】：目的讨论宫颈非鳞状细胞恶性肿瘤(以下简称非鳞癌)的临床特征、诊断、卵巢转移情况及预后。方法对中国人民解放军陆军总医院2010年1月至2016年5月收治的35例宫颈非鳞癌患者与同期228例宫颈鳞癌患者的临床及病理资料进行回顾性分析。结果非鳞癌患者占同期宫颈恶性肿瘤的13.3%。非鳞癌的宫颈细胞学检测阳性率较低(60%)。绝经前与绝经后非鳞癌发病的组织病理类型差异有统计学意义(P0.05)。非鳞癌患者以阴道排液症状就诊的比例及宫颈肉眼观呈内生型的比例明显高于同期鳞癌组(P0.05)。非鳞癌中保留卵巢组与未保留卵巢组5年生存率差异无统计学意义(P0.05)。宫颈非鳞癌的5年生存率明显低于同期鳞癌(P0.05)。结论临床医生对于宫颈非鳞癌的早期诊断需要提高警惕,减少漏诊及误诊率。非鳞癌的预后较鳞癌差,临床分期、淋巴结转移、局部大病灶、宫颈深间质浸润是影响预后的因素。对于早期非鳞癌的年轻患者,仍可考虑保留一侧正常卵巢。
[Abstract]:Objective to discuss the clinical features, diagnosis, ovarian metastasis and prognosis of non-squamous cell carcinoma of the cervix. Methods the clinical and pathological data of 35 patients with non-squamous cell carcinoma of the cervix and 228 patients with squamous cell carcinoma of the cervix were retrospectively analyzed from January 2010 to May 2016 in the Army General Hospital of the Chinese people's Liberation Army. Results Non-squamous cell carcinoma (NSCC) accounted for 13.3% of cervical malignant tumors in the same period. The positive rate of cervical cytology was lower (60%) in non-squamous cell carcinoma. The histopathological types of premenopausal and postmenopausal non-squamous cell carcinoma were significantly different (P0.05). The proportion of patients with non-squamous cell carcinoma (NSCC) who were diagnosed with vaginal effusion symptom and cervical naked view was obviously higher than that of squamous cell carcinoma group (P0.05). There was no significant difference in 5-year survival rate between ovarian-preserving group and non-ovarian group in non-squamous cell carcinoma (P0.05). The 5-year survival rate of non-squamous cell carcinoma of cervix was significantly lower than that of squamous cell carcinoma in the same period (P0.05). Conclusion clinicians should be vigilant in the early diagnosis of cervical non-squamous cell carcinoma and reduce the rate of missed diagnosis and misdiagnosis. The prognosis of non-squamous cell carcinoma was worse than that of squamous cell carcinoma, clinical stage, lymph node metastasis, local large lesion and deep interstitial invasion of cervix were the factors influencing prognosis. For young patients with early non-squamous cell carcinoma, one side of the normal ovary may still be considered.
【作者单位】：中国人民解放军陆军总医院;大连医科大学;

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