Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Health Hospital, Hefei, Anhui Province, China.
Department of Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
Medicine (Baltimore). 2022 Dec 16;101(50):e32004. doi: 10.1097/MD.0000000000032004.
We aimed to explore the clinicopathological characteristics and prognostic risk factors of cervical cancer in patients aged ≤35 years. A total of 256 cervical cancer patients treated at Anhui Medical University Affiliated Maternity and Child Health Hospital and The First Affiliated Hospital of Anhui Medical University from January 2016 to October 2018 were divided into ≤35-year-old (n = 136) and >35-year-old (n = 120) groups. Their clinicopathological characteristics and 3-year cumulative disease-free survival (DFS) and overall survival (OS) rates were compared. The factors influencing the 3-year cumulative DFS rate of patients in the ≤35-year-old group were analyzed using univariate and multivariate Cox regression models. The human papillomavirus (HPV) infection rate, incidence rate of contact vaginal bleeding, depth of cervical interstitial infiltration, and incidence rates of parametrial metastasis and vascular infiltration were all significantly higher in the ≤35-year-old group than in the >35-year-old group. The 3-year cumulative DFS rates of all patients and those with HPV infection and contact vaginal bleeding were significantly lower in the ≤35-year-old group than in the >35-year-old group (69.12% vs. 77.50%, 68.29% vs. 80.85%, and 66.04% vs. 81.48%) (log-rank χ2 = 7.429, 4.339, and 4.276, P < .05). Depth of cervical interstitial infiltration >4 mm, parametrial metastasis, lymph node metastasis, and vascular infiltration were independent risk factors for the prognosis of cervical cancer patients aged ≤35 years (P < .05). Cervical cancer aged ≤35 years have a worse postoperative prognosis than those aged >35 years, which is affected by the depth of cervical interstitial infiltration >4 mm, parametrial metastasis, lymph node metastasis, and vascular infiltration. Therefore, it is necessary to identify more effective treatment methods for young patients with cervical cancer to improve the therapeutic effect and reduce the risk of recurrence and metastasis.
我们旨在探讨≤35 岁宫颈癌患者的临床病理特征和预后危险因素。回顾性分析 2016 年 1 月至 2018 年 10 月在安徽医科大学附属妇幼保健院和安徽医科大学第一附属医院治疗的 256 例宫颈癌患者的临床病理资料,根据年龄分为≤35 岁组(n=136)和>35 岁组(n=120)。比较两组患者的临床病理特征和 3 年累积无病生存率(DFS)和总生存率(OS)。采用单因素和多因素 COX 回归模型分析影响≤35 岁组患者 3 年累积 DFS 率的因素。结果显示,≤35 岁组患者的人乳头瘤病毒(HPV)感染率、接触性阴道出血发生率、宫颈间质浸润深度、宫旁转移和血管浸润发生率均明显高于>35 岁组。所有患者、HPV 感染患者和接触性阴道出血患者中,≤35 岁组的 3 年累积 DFS 率明显低于>35 岁组(69.12%比 77.50%,68.29%比 80.85%,66.04%比 81.48%)(log-rank χ2=7.429、4.339 和 4.276,P<0.05)。宫颈间质浸润深度>4mm、宫旁转移、淋巴结转移和血管浸润是影响≤35 岁宫颈癌患者预后的独立危险因素(P<0.05)。结论:≤35 岁宫颈癌患者术后预后较>35 岁患者差,与宫颈间质浸润深度>4mm、宫旁转移、淋巴结转移和血管浸润有关。因此,有必要为年轻宫颈癌患者寻找更有效的治疗方法,以提高治疗效果,降低复发和转移风险。