[Analysis of 174 cases with cervical cancer in women under 35 years old].
OBJECTIVE
To analyse the prevalence, etiology, presentation, preserving ovary and prognosis of cervical cancer in women under 35 years old.


METHODS
The clinical information of 174 patients were retrospectively analysed.


RESULTS
The percentage of new cervical cancer cases from 1991 to 2001 was 1.2%, 1.2%, 4.3%, 4.2%, 4.6%, 4.5%, 7.3%, 9.0%, 10.7%, 9.4%, 10.8%, respectively (P < 0.01). Contact bleeding was the main symptom that occurred in 101 cases (101/174, 58.0%). Cervicitis was incorrectly diagnosed in 45 cases (45/174, 25.9%). Sex irregularities occurred in 51 cases (51/174, 29.3%). The number of cases with carcinoma in situ, stage I, stage II, stage III was 22, 40, 94, 18, respectively. There are 29 cases with lymph vascular involvement, 60 with 1/2 or more penetration of the cervical stroma. The incidence of HPV16/18 infection was 34%. The ovarian metastasis was 0.8%. The 5 year survival rate of stage I - III was 71.6%, 60.4% and 13.3%, respectively (P < 0.01). COX regression analysis indicated that stage, lymph-vascular involvement and the depth of tumor infiltration were independently prognostic factors. For patients with one risk factor after radical surgery, the survival of patients with adjuvant radiation therapy and chemotherapy or not was 100%, 88%, respectively (P > 0.05). For patients with two or more risk factors, it was 68%, 1/7, respectively (P < 0.05).


CONCLUSIONS
There is an increasing prevalence of cervical cancer in women under 35 years old, which is possibly related to the sexual transition. The preserving ovary in young cervical cancer patients is safe and effective. Patients with late stage, lymph-vascular involvement and deep infiltration of cervical stroma have poor prognosis. Adjuvant treatment may be helpful for patients with 2 or more risk factors after radical surgery.
Zhang
Mei-qin
MQ
Department of Gynecologic Oncology, Cancer Hospital, Fudan University, Shanghai 200032, China.
Chen
Ming-zhi
MZ
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010052:Ovariectomy; D011379:Prognosis; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*