Department of Gynecological Oncology Radiumhemmet, Karolinska University Hospital, Solna, Karolinska Institute, Stockholm, Sweden.
Cancer. 2010 May 15;116(10):2343-9. doi: 10.1002/cncr.24971.
This study is a representation of 90 years of experience with carcinoma of the uterine cervix in pregnancy. The objective was to retrospectively study changes in the distribution of cervical carcinoma (CC) by age, disease stage, histopathology, survival, and the development of second primary cancers.
Altogether, 18,474 women with newly diagnosed CC were examined and treated at the Radiumhemmet between 1914 and 2004, including 9247 women who were of a childbearing age (<50 years) and 219 women who were pregnant.
The mean patient age declined from 35 years (during 1914-1943) to 32.2 years (during 1960-2004). Similarly, the age range changed from ages 23 to 51 years (during 1914-1943) to ages 21 to 47 years (during 1960-2004). The relative incidence for all women aged <50 years who were treated for CC dropped considerably from 4.2% (during 1914-1943) to 1.2% (during 1960-2004), which translated into a reduction of by approximately 66%. At the time of diagnosis, stage I CC was observed in 75.6% of patients during 1960 to 2004 compared with 24.8% of patients during 1914 to 1943. The 10-year actuarial survival rate improved significantly during the study period from 27% (1914-2004) to 79% (1960-2004). The 10-year cause-specific cumulative actuarial survival rate for 41 women who were treated during 1960 to 2004 did not differ statistically from the rate for an age-matched, stage-matched, and histopathology-matched control series from the total cohort of women with CC who were treated at the Radiumhemmet during the same period (log-rank test; P = .85).
During the study period, the incidence of CC during pregnancy declined, the cases were discovered at earlier stages, and survival improved. Furthermore, there was no increase in second primary cancers, and pregnancy did not appear to influence prognosis.
本研究代表了 90 年来妊娠合并宫颈癌的经验。目的是回顾性研究宫颈癌（CC）的分布变化，包括年龄、疾病分期、组织病理学、生存率和第二原发癌的发展。
1914 年至 2004 年间，共有 18474 名新诊断为 CC 的女性在镭医院接受检查和治疗，其中 9247 名女性处于生育年龄（<50 岁），219 名女性怀孕。
患者平均年龄从 35 岁（1914-1943 年）下降到 32.2 岁（1960-2004 年）。同样，年龄范围从 23 岁到 51 岁（1914-1943 年）缩小到 21 岁到 47 岁（1960-2004 年）。所有<50 岁的接受 CC 治疗的女性的相对发病率从 4.2%（1914-1943 年）急剧下降到 1.2%（1960-2004 年），减少了约 66%。在诊断时，1960 年至 2004 年期间，I 期 CC 占患者的 75.6%，而 1914 年至 1943 年期间仅占 24.8%。在研究期间，10 年生存率从 27%（1914-2004 年）显著提高到 79%（1960-2004 年）。1960 年至 2004 年期间接受治疗的 41 名女性的 10 年累积特定原因生存率与同期镭医院治疗的 CC 总队列中年龄、分期和组织病理学匹配的对照组系列的生存率无统计学差异（对数秩检验；P=.85）。
在研究期间，妊娠合并宫颈癌的发病率下降，病例发现较早，生存率提高。此外，第二原发癌无增加，妊娠似乎不影响预后。
