Analysis of clinical characteristics and prognosis influencing factors of young patients with cervical cancer

Abstract

Objective To explore the clinical features of cervical cancer young patients (≤35 years old) and related factors affecting on prognosis. Methods From March 2010 to March 2012, a total of 157 cervical cancer patients hospitalized in People′s Hospital of Longhua District of Shenzhen were chosen as research subjects. According to their age, 82 cases were included into ≤ 35 years old group, and 75 cases were included into > 35 years old group. The t test or chi-square test was used to compare the differences of general and cervical cancer related clinical data between two groups of cervical cancer patients. Patients in ≤ 35 years old group were followed up for 5 years, and survival and death were used as prognostic judgment indicators for cervical cancer young patients. Univariate analysis was used to explore the risk factors which affected on prognosis of cervical cancer young patients in 16 factors, including patient age, education level, place of residence, human papillomavirus (HPV) infection, initial sexual life age, number of births, tumor diameter, tumor pathology, tumor pathological grade, depth of cervical interstitial invasion, lymph node metastasis, tumor parametrial metastasis, vascular invasion, treatments, tumor recurrence and family history of cervical cancer. With existing research results and clinical experience, multivariate unconditional logistic regression analysis were performed in statistically significant factors in the results of univariate analysis to explore the independent risk factors which affected on prognosis of cervical cancer young patients. This research was in line with the World Medical Association Declaration of Helsinki revised in 2013. Results ①The initial sexual life age of cervical cancer patients in ≤ 35 years old group [(21.1±2.6) years old] was younger than that in > 35 years old group [(22.9±2.1) years old]. The incidence of HPV infection, contact bleeding, adenocarcinoma, tumor parametrial metastasis and vascular invasion of cervical cancer patients in ≤ 35 years old group (92.7%, 78.0%, 19.5%, 56.1%, 37.8%) were all higher than those in > 35 years old group (77.3%, 45.3%, 6.7%, 36.0%, 21.3%), and the differences were statistically significant(t=4.745, χ2=7.381, 17.775, 5.888, 6.360, 5.067; all P<0.05). ②Univariate analysis of prognosis influencing factors of cervical cancer young patients with survival and death of prognostic judgment indicators showed that there were 13 factors has statistical significance in patient age, initial sexual life age, number of births, tumor diameter, tumor pathology, tumor pathological grade, depth of cervical interstitial invasion, lymph node metastasis, tumor parametrial metastasis, vascular invasion, treatments, tumor recurrence and family history of cervical cancer (t=2.621, 4.032, 2.699, 2.746; χ2=11.721, 15.571, 8.313, 4.877, 9.015, 13.577, 4.911, 3.855, 9.526; all P<0.05). ③Multivariate unconditional logistic regression analysis of prognosis influencing factors of cervical cancer young patients in 13 factors showed that the pathological type of tumor (OR=6.214, 95%CI: 1.214-19.154, P<0.05), tumor pathological grade (OR=10.547, 95%CI: 2.017-23.574, P<0.05 ), depth of cervical interstitial invasion (OR=3.019, 95%CI: 1.011-9.116, P<0.05), lymph node metastasis (OR=2.214, 95%CI: 1.215-8.067, P<0.05), tumor parametrial metastasis (OR=1.368, 95%CI: 1.084-7.008, P<0.05), tumor vascular invasion (OR=2.007, 95%CI: 1.006-11.068, P<0.05), treatments (OR=1.097, 95%CI: 1.068-9.106, P<0.05) and tumor recurrence (OR=9.164, 95%CI: 2.167-35.168, P<0.05) were all independent risk factors of the prognosis of cervical cancer young patients. Conclusions Cervical cancer young patients have a higher grade of malignancy. There are many risk factors affecting on the prognosis of cervical cancer young patients. Early prevention, screening, diagnosis and treatment of cervical cancer should be carried out to reduce the number of cervical cancer young patients and improve the prognosis. Key words: Uterine cervical neoplasms; Prognosis; Risk factors; Female