1.A real-world study of first-line albumin-bound paclitaxel in the treatment of advanced pancreatic cancer in China
Juan DU ; Xin QIU ; Jiayao NI ; Qiaoli WANG ; Fan TONG ; Huizi SHA ; Yahui ZHU ; Liang QI ; Wei CAI ; Chao GAO ; Xiaowei WEI ; Minbin CHEN ; Zhuyin QIAN ; Maohuai CAI ; Min TAO ; Cailian WANG ; Guocan ZHENG ; Hua JIANG ; Anwei DAI ; Jun WU ; Minghong ZHAO ; Xiaoqin LI ; Bin LU ; Chunbin WANG ; Baorui LIU
Chinese Journal of Oncology 2024;46(11):1038-1048
Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P<0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.
2.Clinical characteristics and all-cause mortality influencing factors of 176 patients with Keshan disease
Shujuan LI ; Ying HONG ; Jianzhong BAO ; Rong LUO ; Huihui MA ; Hongmei ZHANG ; Wei CAI ; Feng LI ; Jinshu LI ; Hui HUANG ; Mingjiang LIU ; Anwei WANG ; Ningbo HUANG ; Xiaoping LI
Chinese Journal of Endemiology 2024;43(6):482-486
Objective:To analyze the clinical characteristics and all-cause mortality influencing factors of patients with Keshan disease.Methods:Clinical data of patients with Keshan disease from Keshan disease areas in Sichuan Province and Yunnan Province were collected and retrospectively analyzed for clinical characteristics and survival status during regular follow-up. According to the survival status of patients, the survey subjects were divided into a survival group and a death group. All-cause mortality (referring to the death caused by various reasons throughout the follow-up period) was used as the study endpoint. Kaplan-Meier (K-M) survival curve analysis and log-rank χ 2 test were performed, univariate and multivariate Cox regression analysis were used for all-cause mortality factor analysis. Results:A total of 176 patients with Keshan disease were collected, including 92 cases in Sichuan Province and 84 cases in Yunnan Province. Among all the patients, there were 105 males, accounting for 59.66%, and 71 females, accounting for 40.34%. The age was (53.89 ± 13.19) years old. Thirty-five cases died from all causes, with a mortality rate of 19.89%. There were significant differences in age ( t = 2.09, P = 0.038), New York Heart Association (NYHA) cardiac function grading (χ 2 = 14.62, P < 0.001) and ventricular premature contraction (χ 2 = 6.82, P = 0.009) between the survival group and the death group. K-M survival curve analysis showed that patients with Keshan disease complicated by premature ventricular contraction and high NYHA cardiac function grading (Ⅲ and Ⅳ) had higher all-cause mortality (log-rank χ 2 = 8.72, 22.49, P < 0.05). Univariate Cox regression analysis showed that NYHA cardiac function grading and ventricular premature contraction ( HR = 3.09, 2.71, P < 0.05) were predictive influencing factors for all-cause mortality in patients with Keshan disease. Multivariate Cox regression analysis showed that NYHA cardiac function grading ( HR = 6.57, P = 0.002) and ventricular premature contraction ( HR = 2.98, P = 0.050) were independent factors for all-cause mortality in patients with Keshan disease. Conclusions:Among 176 patients with Keshan disease, the number of patients with poor cardiac function (NYHA cardiac function grading Ⅲ and Ⅳ) and arrhythmia is high. NYHA cardiac function grading and ventricular premature contractions are independent influencing factors for all-cause mortality in patients with Keshan disease.
3.A real-world study of first-line albumin-bound paclitaxel in the treatment of advanced pancreatic cancer in China
Juan DU ; Xin QIU ; Jiayao NI ; Qiaoli WANG ; Fan TONG ; Huizi SHA ; Yahui ZHU ; Liang QI ; Wei CAI ; Chao GAO ; Xiaowei WEI ; Minbin CHEN ; Zhuyin QIAN ; Maohuai CAI ; Min TAO ; Cailian WANG ; Guocan ZHENG ; Hua JIANG ; Anwei DAI ; Jun WU ; Minghong ZHAO ; Xiaoqin LI ; Bin LU ; Chunbin WANG ; Baorui LIU
Chinese Journal of Oncology 2024;46(11):1038-1048
Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P<0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.
4.V-Y advancement flap for treatment of children with foot spoke injury: Report of 8 cases
Anwei FAN ; Dong LI ; Lu ZHANG ; Yuxiao LIU ; Ye LI ; Lishuang GU
Chinese Journal of Microsurgery 2022;45(5):504-507
Objective:To investigate the effect of V-Y advancement flap in the treatment of foot spoke injury in children.Methods:Clinical data of 8 patients, including 6 males and 2 females aged 2.5-5.0 (mean, 3.5) years old with foot spoke injury admitted to the Third Ward of Department of Orthopaedic Surgery, Xingtai General Hospital of North China Medical and Health Group from June 2019 to October 2021, were analysed retrospectively. Soft tissue defect around achilles tendon was 2.0 cm×3.0 cm-2.5 cm×4.0 cm. The size of the flap was 2.5 cm×3.5 cm-3.0 cm×4.5 cm. All patients underwent emergency debridement followed by V-Y advancement flap repair, and direct suture of the skin and tissues at donor site. The blood supply, survival and healing of flap of donor site were observed after operation. The shape of the heel and the functional recovery of the affected limb were examined on regular basis at the outpatient clinic.Results:All 8 flaps survived and the wounds had primary healing. The patients entered the follow-up for 6-12 months, with an average of 8 months. The texture and colour of the flap recipient site were good. The shape of the flap pedicle, the donor site and recipient site were satisfactory. The shoes wearing of the affected foot were not affected after surgery. The ankle function was good. The average extension was 25.8°(20°-30°), plantar flexion 32.5°(25°-40°), and the foot sensation and motion were close to normal. The average foot function score on American Association on Foot and Ankle Surgery(AOFAS) was 91.7±6.4. Five cases were excellent and 3 were good.Conclusion:The V-Y advancement flap demonstrates an ideal alternative method for treatment of small area of soft tissue defect around Achilles tendon, due to the simple operation, satisfactory shape of flap after repair, and favorable limb function.
5.Clinical effects of retrograde anterolateral thigh perforator flaps assisted with computed tomography angiography in repairing skin and soft tissue defects around the knee or in proximal lower leg
Shuming ZHAO ; Yaming LIU ; Na LIU ; Hongliang ZHANG ; Zhanfeng SONG ; Wenhua GAO ; Yuehui LAN ; Anwei FAN ; Xueliang LIU
Chinese Journal of Burns 2021;37(4):356-362
Objective:To investigate the clinical effects of retrograde anterolateral thigh perforator flaps assisted with computed tomography angiography (CTA) in repairing skin and soft tissue defects around the knee or in proximal lower leg.Methods:A retrospective cohort study was conducted. From May 2015 to October 2019, 17 patients with skin and soft tissue defects around the knee or in proximal lower leg were admitted to the Department of Orthopedics of Jizhong Energy Xingtai Mig General Hospital, including 12 males and 5 females, aged 16-65 years, with an average age of 35 years. The areas of skin and soft tissue defects after debridement ranged from 6.0 cm×3.0 cm to 15.0 cm×9.0 cm. The retrograde anterolateral thigh perforator flaps were designed according to the origin and distribution of the perforating branches in flaps and the length of the vascular pedicle examined with CTA and the condition of the wound to repair the wounds. The areas of resected flaps ranged from 6.5 cm×3.5 cm to 15.5 cm×9.5 cm. The wounds in donor sites of flaps were sutured directly or covered with medium-thickness skin grafts from healthy upper leg. The sources of the perforating branches in flaps were recorded. The lateral circumflex femoral artery, its branches, and the relative length of the vascular pedicle were compared between preoperative CTA detection and intraoperative observation. The survivals of the flaps were observed. At the last follow-up, the effects of flaps in repairing wounds were evaluated according to evaluation standard of efficacy satisfaction; the motion ranges of flexion and extension of the knee joint were measured, and the knee joint function was evaluated according to the Hohl knee joint function evaluation standard; the sensory function in the flap area was evaluated according to the sensory function evaluation standard formulated by the British Medical Research Council; the wound healing and the occurrence of complication affecting motor function of limb of flap donor sites was observed. Data were statistically analyzed with paired sample t test. Results:The perforating branches in flaps originated from descending branches, oblique branches, and rectus femoris branches of lateral circumflex femoral artery in 7, 6, and 4 patients, respectively. The flaps with blood supply from descending branches, oblique branches, and rectus femoris branches of lateral circumflex femoral artery were type 1, 2, and 3 retrograde anterolateral thigh perforator flaps, respectively. The preoperative CTA examination of lateral circumflex femoral artery and its branches were consistent with those observed during operation. The relative lengths of vascular pedicles of type 1, 2, and 3 retrograde anterolateral thigh perforator flaps calculated after CTA examination were 0.32±0.13, 0.56±0.07, and 0.56±0.15, which were close to 0.35±0.12, 0.52±0.10, and 0.53±0.12 measured and calculated during operation, respectively ( t=0.45, 0.80, 0.31, P>0.05). All flaps survived in 17 cases without vascular crisis. At the last follow-up, 16 patients were satisfied with effects of flaps in wound repair, with 1 patient feeling average about the effect; the flexion range of knee joint was 100-120°, and the extension range of knee joint was -2-0°; knee joint function was evaluated as excellent in 9 cases, good in 7 cases, and poor in 1 case; the sensory function of the flap area reached S 4 level in 2 cases, S 3 level in 8 cases, and S 2 level in 7 cases; the wounds in flap donor sites healed well; there was no adverse effect in motor function of limbs. Conclusions:Retrograde anterolateral thigh perforator flap is an effective method for repairing skin and soft tissue defects around the knee or in proximal lower leg. Preoperative CTA examination can fully show the anatomical characteristics of the branches of the lateral circumflex femoral artery and the perforating vessels of each branch, which can guide preoperative flap design and operation, thus shortening operation time and improving flap survival rate, with good clinical effects.
6.The head of second metatarsal bone and flap repair the lateral malleolus compound tissues defect in children
Shuming ZHAO ; Na LI ; Xueliang LIU ; Hongliang ZHANG ; Zhanfeng SONG ; WenHua GAO ; Anwei FAN ; Yuehui LAN
Chinese Journal of Plastic Surgery 2020;36(10):1139-1143
Objective:To explore the clinic effects of the head of second metatarsal bone and flap for bone and skin defect at lateral malleolus in children.Methods:Between July 2009 and May 2018, 4 children with ankle bone and skin and soft tissue defects in the Jizhong Energy Xingtai Mig General Hospital were selected, including 3 boys and 1 girl aged 4-13 years old. All cases were lateral malleolus defect with adjacent skin defect, the range of skin defect was 2.0 cm×2.0 cm -4.0 cm×5.0 cm, and the range of bone defect was 1.0-3.0 cm. The area of the flap was 2.5 cm×2.5 cm-4.5 cm × 5.5 cm, and the length of the second metatarsal head was 1.0-3.0 cm. The donor site was closed directly. After the operation, X-rays was performed to evaluate whether the ankle space and lateral malleolus longitudinal development was synchronized with the uninjured limb. Ankle joint function recovery was evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS). The outcomes of donor foot range of motion, weight-bearing, and walking were observed.Results:All the composite tissue flap survived with good blood circulation, and all the donor sites healed well. All the child patients were followed up for 0.5-2.0 years. The color and elasticity of the flaps were good, without cicatricial contracture. The patients had no inversion of ankle joint, with satisfying loading and walking function. Imaging evaluation showed that the space between ankle points and the longitudinal development of lateral malleolus were roughly synchronous with the healthy side. Two cases were graded as excellent and 2 as good according to the standard of the AOFAS.The donor's foot had normal flexion and extension function, without instability.Conclusions:The head of second metatarsal bone and flap can repair the epiphysis and soft tissue defect of lateral malleolus in children at one stage, and the reconstructed lateral malleolus can develop with the growth of children. It is a satisfactory method of reconstructing the traumatic defect of lateral malleolus in children.
7.The head of second metatarsal bone and flap repair the lateral malleolus compound tissues defect in children
Shuming ZHAO ; Na LI ; Xueliang LIU ; Hongliang ZHANG ; Zhanfeng SONG ; WenHua GAO ; Anwei FAN ; Yuehui LAN
Chinese Journal of Plastic Surgery 2020;36(10):1139-1143
Objective:To explore the clinic effects of the head of second metatarsal bone and flap for bone and skin defect at lateral malleolus in children.Methods:Between July 2009 and May 2018, 4 children with ankle bone and skin and soft tissue defects in the Jizhong Energy Xingtai Mig General Hospital were selected, including 3 boys and 1 girl aged 4-13 years old. All cases were lateral malleolus defect with adjacent skin defect, the range of skin defect was 2.0 cm×2.0 cm -4.0 cm×5.0 cm, and the range of bone defect was 1.0-3.0 cm. The area of the flap was 2.5 cm×2.5 cm-4.5 cm × 5.5 cm, and the length of the second metatarsal head was 1.0-3.0 cm. The donor site was closed directly. After the operation, X-rays was performed to evaluate whether the ankle space and lateral malleolus longitudinal development was synchronized with the uninjured limb. Ankle joint function recovery was evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS). The outcomes of donor foot range of motion, weight-bearing, and walking were observed.Results:All the composite tissue flap survived with good blood circulation, and all the donor sites healed well. All the child patients were followed up for 0.5-2.0 years. The color and elasticity of the flaps were good, without cicatricial contracture. The patients had no inversion of ankle joint, with satisfying loading and walking function. Imaging evaluation showed that the space between ankle points and the longitudinal development of lateral malleolus were roughly synchronous with the healthy side. Two cases were graded as excellent and 2 as good according to the standard of the AOFAS.The donor's foot had normal flexion and extension function, without instability.Conclusions:The head of second metatarsal bone and flap can repair the epiphysis and soft tissue defect of lateral malleolus in children at one stage, and the reconstructed lateral malleolus can develop with the growth of children. It is a satisfactory method of reconstructing the traumatic defect of lateral malleolus in children.
8.Investigation of iodine nutrition among different populations after adjusting the salt iodine concentration in Dali City of Yunnan Province
Haitao ZHANG ; Anwei WANG ; Xiuqin LIU ; Feng YE ; Yuxi GUO ; Shujuan LI ; Rongji CAO ; Wenli HUANG
Chinese Journal of Endemiology 2019;38(2):130-133
Objective After implementation of new standard iodized salt,to comprehensively assess the iodine nutrition levels of different populations in Dali City of Yunnan Province.Methods From 2012 to 2015,in Dali City,there were 5 districts divided into east,west,south,north and middle,each district selected 1 township (town),and each township (town) selected 4 administrative villages,15 households for edible salt in each administrative village were sampled,and the salt iodine content was measured by "General Test Method in Salt Industry Determination of Iodine" (GB/T 13025.7-2012).In 2014,in the five districts of east,west,south,north and middle of Dali City,one township (town) was selected,and 20 pregnant women in the early,middle and late stages,respectively,20 lactating women,20 ordinary healthy adults and 20 children aged 0 to 4 were selected from each township (town);one primary school in each township (town) was selected in each district,and 40 students aged 8-10 years old were selected from each primary school as the survey objects.The urine samples of the survey objects were collected,and the urinary iodine content was measured by "Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry" (WS/T 107-2006).In 2015,in each administrative village of Dali,a water source with the largest number of drinking people was investigated,and water iodine was detected by the "Method of Water Iodine Detection Suitable for Iodine Deficiency and High Iodine Areas".Through questionnaires,the sources of iodine supplementation for pregnant and lactating women were investigated.Results The qualified iodized salt consumption rate of residents was higher than 90% per year from 2012 to 2015,and median of salt iodine decreased from 29.38 mg/kg (2012) to 24.96 mg/kg (2015).The medians of urinary iodine in different populations were 136.85 μg/L for pregnant women (n =356),102.63 μg/L for lactating women (n =111),164.03 μg/L for adults (n =163),209.61 μg/L for 8-10 years old children (n =200),157.27 μg/L for children aged 0-< 2 years old (n =57),and 134.08 μg/L for 2-4 years old children (n =50).The median of iodine content of drinking water (n =142) in Dali was 0.62 μg/L,the range of iodine content was 0.00-9.92 μg/L.The average intake frequencies of iodine-rich seaweed for pregment women and lacting women were 0.99,1.07 time/month,respectively,only 1.99% (9/453) of the population supplemented iodine through multivitamin and minerals tablets.Conclusions After reduction of salt iodine content,the iodine nutrition of populations in Dali City (a low water iodine region) is generally at an appropriate level.Maintaining a higher level of qualified iodized salt consumption rate,strengthening the monitoring of different populations and promotion of healthy behaviors are key steps in prevention and control of the disease in the future.
9.Trend in proportion and clinicopathological characteristics of young women with stageⅠa2 toⅡa2 cervical cancer
Wei WANG ; Min HAO ; Chunlin CHEN ; Ping LIU ; Bin LING ; Shan KANG ; Anwei LU ; Wuliang WANG ; Weidong ZHAO ; Qianyong ZHU ; Yueyang ZHAO ; Hongwei ZHAO ; Shuangling JIN ; Yan NI ; Jinghe LANG
Chinese Journal of Obstetrics and Gynecology 2019;54(10):666-672
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 stageⅠa2 toⅡa2 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 stageⅠ, 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 stageⅠa2 toⅡa2 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.
10. Trend in proportion and clinicopathological characteristics of young women with stage Ⅰa2 to Ⅱa2 cervical cancer
Wei WANG ; Min HAO ; Chunlin CHEN ; Ping LIU ; Bin LING ; Shan KANG ; Anwei LU ; Wuliang WANG ; Weidong ZHAO ; Qianyong ZHU ; Yueyang ZHAO ; Hongwei ZHAO ; Shuangling JIN ; Yan NI ; Jinghe LANG
Chinese Journal of Obstetrics and Gynecology 2019;54(10):666-672
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 (

Result Analysis
Print
Save
E-mail