Trend in proportion and clinicopathological characteristics of young women with stage Ⅰa2 to Ⅱa2 cervical cancer
10.3760/cma.j.issn.0529-567x.2019.10.004
- VernacularTitle: 年轻Ⅰa2~Ⅱa2期子宫颈癌患者的构成比变化趋势及临床病理特征分析
- Author:
Wei WANG
1
;
Min HAO
1
;
Chunlin CHEN
2
;
Ping LIU
2
;
Bin LING
3
;
Shan KANG
4
;
Anwei LU
5
;
Wuliang WANG
6
;
Weidong ZHAO
7
;
Qianyong ZHU
8
;
Yueyang ZHAO
1
;
Hongwei ZHAO
9
;
Shuangling JIN
10
;
Yan NI
11
;
Jinghe LANG
12
Author Information
1. Department of Obstetrics and Gynecology, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China
2. Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
3. Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing 100029, China
4. Department of Gynecology, Fourth Hospital, Hebei Medical University, Shijiazhuang 050019, China
5. Department of Obstetrics and Gynecology, Shenzhen Hospital, Southern Medical University, Shenzhen 518101, China
6. Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China
7. Department of Obstetrics and Gynecology, Anhui Provincial Hospital, Hefei 236048, China
8. Department of Obstetrics and Gynecology, Henan Provincial People's Hospital, Zhengzhou 450003, China
9. Department of Gynecology, Shanxi Provincial Cancer Hospital, Taiyuan 030001, China
10. Department of Obstetrics and Gynecology, Peace Hospital Affiliated with Changzhi Medical College, Changzhi 046000, China
11. Department of Obstetrics and Gynecology, Yuncheng Central Hospital in Shanxi Province, Yuncheng 044000, China
12. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
- Publication Type:Clinical Trail
- Keywords:
Uterine cervical neoplasms;
Age factors;
Papillomavirus infections;
Carcinoma, squamous cell;
Neoplasm invasiveness;
Neoplasm staging
- From:
Chinese Journal of Obstetrics and Gynecology
2019;54(10):666-672
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the 13 years trend in proportion, risks factors and clinicopathological characteristics of young women with stage Ⅰa2 to Ⅱa2 cervical cancer by using multi-center data of cervical cancer in China.
Methods:The clinicopathological data of 46 313 patients with cervical cancer treated from 37 hospitals in China were obtained from January 2004 to December 2016. Using clinical and pathologic data, each patient's stage was reclassified by the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system. A total of 19 041 patients were selected according to the following criteria: FIGO stage Ⅰa2 to Ⅱa2, underwent type B or C radical hysterectomy and pelvic lymphadenectomy. All the patients were divided into two groups: the study group of 1 888 patients aged 35 years or younger and the control group of 17 153 patients aged over 35 years. The 13 years trend in proportion of young women with stage Ⅰa2 to Ⅱa2 cervical cancer, risks factors and clinicopathological characteristics of two groups were retrospectively analyzed.
Results:(1) The total number of hospitalized patients with stage Ⅰa2 to Ⅱa2 cervical cancer increased annually. However, a downward trend of patients aged 35 years or younger was observed (P<0.01) . The constituent ratio of patients aged 35 years or younger was significantly greater during 2004—2010 than that during 2011—2016 [12.6% (820/6 484) and 8.5% (1 068/12 557) , respectively; χ2=82.101, P<0.01]. (2) Compared with patients aged over 35 years, patients aged 35 years or younger had an earlier age at menarche, a later age at marriage, lesser gravida and parity (all P<0.01). The positive rate of high-risk HPV infection was not statistically different between two groups (all P>0.05). (3) The proportions of stage Ⅰ, exophytic type and non-squamous histological type in patients aged 35 years or younger were clearly higher than those in patients aged over 35 years (83.4% vs 68.5%, P<0.01; 63.2% vs 56.2%, P<0.01; 13.9% vs 12.0%, P<0.05, respectively). Whereas the poor differentiation ratios of the two groups had no statistical significance (P>0.05). (4) As for the postoperative pathological risk factors, the rate of surgical margin involvement in patients aged 35 years or younger was lower than that aged over 35 years (1.1% vs 1.8%, P<0.05), and the rate of depth of stromal invasion >1/2 in patients aged 35 years or younger was lower than that in patients aged over 35 years (40.1% vs 50.9%, P<0.01). In addition, there were no significant difference in parametrial margin involvement, tumor size and lymph vascular space invasion between two groups (all P>0.05).
Conclusions:The trend in proportion among hospitalized patients for stage Ⅰa2 to Ⅱa2 cervical cancer in young women is decreasing yearly. Compared with cervical cancer in middle-aged and elderly women, cervical cancer in young women have an earlier age at menarche, a higher proportion of stage Ⅰ patients and non-squamous histological type. In terms of the postoperative pathological risk factors, the rate of surgical margin involvement and depth of stromal invasion >1/2 in young women with cervical cancer are lower than in middle-aged and elderly women.
