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目的:探讨10年来宫颈癌住院患者的临床特点变化及“两癌筛查”开展5年以来宫颈癌筛查的作用。方法:回顾性分析2005年1月至2014年12月在北京大学第一医院妇产科确诊为宫颈癌的718例住院患者的临床资料,按户籍所在地分为北京市和外省市两组;按“两癌筛查”前后分为2005~2009年组和2010~2014年组,分别比较基础资料、诊断途径及肿瘤分期等临床特点。结果:110年来我院收治的宫颈癌患者数量呈上升趋势。北京市患者的平均发病年龄、结婚年龄、初产年龄均高于外省市(P<0.05),而中位孕次和产次均低于外省市(P<0.05)。北京市患者中体检发现比例和ⅠA期患者比例均高于外省市(P<0.05)。2“两癌筛查”前后各项指标的比较中,仅筛查后的发病年龄高于筛查前(P<0.05),其他项目的比较差异均无统计学意义(P>0.05)。3北京市患者中以西城区患者最多。外省市患者前3位是河北省、内蒙古自治区和山西省。结论:北京市宫颈癌患者在早婚、早育、多产等高危因素方面优于外省市患者,外省市宫颈癌筛查宣教和实施筛查的力度需进一步加大,扩大体检发现率和ⅠA期发现率。“两癌筛查”的作用尚未体现,还需要长期坚持、广泛开展。
Objective: To investigate the changes of clinical features of inpatients with cervical cancer over the past 10 years and the role of screening of cervical cancer in 5 years of screening of two cancers. Methods: The clinical data of 718 inpatients diagnosed as cervical cancer from the Department of Obstetrics and Gynecology, Peking University First Hospital from January 2005 to December 2014 were retrospectively analyzed. According to the location of the household registration, they were divided into two groups: Beijing and other provinces and cities; According to “two cancer screening ” before and after the 2005 ~ 2009 group and 2010 ~ 2014 group, respectively, compared basic data, diagnostic methods and clinical features such as tumor staging. Results: The number of patients with cervical cancer admitted to our hospital for 110 years is on the rise. The average age at onset, the age at marriage and the age of first trimester in Beijing were higher than those in other provinces (P <0.05), while the median birth weight and times were lower than those in other provinces (P <0.05). The percentage of physical examination in Beijing and the proportion of patients in stage IA were higher than those in other provinces (P <0.05). In comparison of the indexes before and after the two cancer screening, the age of onset after screening alone was higher than that before screening (P <0.05), and there was no significant difference in other items (P> 0.05) . 3 patients in Beijing City West most patients. The top 3 patients in other provinces and cities are Hebei Province, Inner Mongolia Autonomous Region and Shanxi Province. Conclusion: Cervical cancer patients in Beijing are superior to other provinces and cities in the risk of early marriage, early childbirth and prolification. The screening and implementation screening of cervical cancer in other provinces and cities need to be further intensified, and the detection rate and IA Discovery rate. “The role of cancer screening ” has not yet been reflected, but also need long-term adherence, wide range.