[Clinical features and treatment of cervical malignant tumor in young women].
OBJECTIVE
To evaluate clinical characteristics, prognosis, prognostic factors, and the ideal treatment of the young patients with cervical malignant tumor.


METHODS
We analyzed retrospectively 52 cervical malignant tumor patients younger than 35 years (study group) and 45 cervical carcinoma patients older than 50 years (control group) who were admitted in Peking Union Medical College Hospital from 1985 to 2002. The data were analyzed statistically by SPSS10.0. The ovarian functions were evaluated by the questionnaire and the serum sex hormone assay.


RESULTS
In study group, the median age was (31.0 +/- 0.6) years old. The most common clinical symptoms were contact bleeding and irregular bleeding; 55.8% of patients had more than one symptom. HPV positive rate was 20.5%, which was higher than control group significantly (P < 0.05). The percentage of advanced stage (stage II b-stage IV b) of disease in study group and control group were 30.8% and 22.2%, respectively, the difference was significant (P < 0.05). The most common histological type was squamous cell carcinoma (71.2%) in study group, while the percentage of non-squamous cell carcinoma (43.8%) in patients younger than 30 years was much higher than control group (P < 0.05). All the histological type was non-squamous cell carcinoma in the patients younger than 25 years. Histological grade showed that G1, G2, and G3 were 21.2%, 54.5%, and 24.2% respectively in study group. The percentage of bulky cervix (tumor diameter > 4 cm) in study group and control group was 27.9% and 2.7% respectively (P < 0.005). The overall 5-year survival rates were 75.7% in study group, lower than control group (P < 0.05). The COX hazards regression model showed histological type (P = 0.003) and bulky cervix (P = 0.001) were of significant prognostic values.


CONCLUSIONS
There are more advanced stage carcinoma and non-squamous cell carcinoma patients with poor prognosis in study group. The treatment to younger patients should be concerned individually, as well as preservation of reproductive and female endocrine function should be considered.
Zhang
Yu
Y
Department of Obstetrics and Gynecology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China. yszy0913@sina.com
Shen
Keng
K
Gao
Jin-song
JS
Wu
Ming
M
Huang
Hui-fang
HF
Pan
Ling-ya
LY
Lang
Jing-he
JH
D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery / Q000821:virology; D000328:Adult; D000367:Age Factors; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010050:Ovarian Function Tests; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000601:surgery* / Q000821:virology