马荣丽，关铮

·论著·

9例青春期宫颈肿瘤性病变诊治分析

马荣丽，关铮

目的：分析青春期宫颈肿瘤性病变的临床特征，探讨其诊断和治疗措施。方法：回顾性分析中国人民解放军总医院（简称我院）近十年收治的青春期宫颈肿瘤性病变患者的相关资料。结果：青春期宫颈肿瘤性病变者占同期宫颈病变者的0.04％（9/22 283），9例青春期宫颈肿瘤性病变中7例恶性病变，其中5例误诊。B型超声与磁共振成像（MRI）在宫颈恶性病变的诊断中具有一定应用价值。结论：青春期宫颈肿瘤性病变的诊断应注意临床特点，重视最基本的直肠指诊和生殖系统影像学检查，必要时行妇科双合诊可以降低误诊率；治疗以手术为主，必要时联合放化疗，同时要尽最大可能保留其内分泌及生育功能。

青春期；宫颈疾病；化学疗法，辅助；放射疗法，计算机辅助；生育力

【Abstract】Objective:Analyze the clinical features of cervical neoplastic lesions in adolescents and discuss the diagnosis and treatment measures.Methods:Retrospectively analyze the patients who were treated by the department of gynecology in the recent ten years.Results:Adolescent cervical neoplastic lesions accounted for 0.04％（9/22 283）of all cervical lesions during this period.In our study 7 patients were malignant lesions.5 in 7 cases of cervical malignant lesions of this study were misdiagnosed.Ultrasound and MRI have a certain value to diagnoze cervical malignant lesions.Conclusions:Attention should be paid to the clinical characteristics in the diagnosis of adolescent cervical neoplastic lesions and the same as the emphasis on the most basic rectal and digital imaging examination for reproductive system.Gynecological bimanual examination should be conducted when needed to reduce the rate of misdiagnosis.Treatment is given priority to surgery and combined with radiation and chemotherapy if necessary，meanwhile keeping the endocrine and reproductive function as much as possible is necessary.

【Keywords】Puberty；Uterine cervical diseases；Chemotherapy，adjuvant；Radiotherapy，computer-assisted；Fertility

（J Int Obstet Gynecol，2015，42：21-24）

世界卫生组织（WHO）定义10～19岁为青春期，是女性生殖系统发育及第二性征成熟的重要阶段。流行病学调查显示，青春期宫颈肿瘤性病变的发病率极低［1］。近年来有研究资料显示宫颈病变的发病趋于年轻化［2］。由于青春期女性患者多无性生活，使得妇科双合诊及宫颈液基薄层细胞学检查（TCT）的应用在宫颈肿瘤性病变的诊断中受到一定限制，故青春期宫颈肿瘤性病变在诊疗过程中易被忽视。对于青春期宫颈病变尤其恶性病变的治疗，涉及能否保留内分泌及生育功能的问题，因此，早期诊断及合理治疗尤为重要。笔者回顾分析2004—2013年就诊于中国人民解放军总医院（简称我院）的9例青春期宫颈病变的病例资料，并就其诊断及治疗措施进行讨论。……