[Trend in proportion and clinicopathological characteristics of young women with stage â a2 to â ¡a2 cervical cancer].

Objective: To analyze the 13 years trend in proportion, risks factors and clinicopathological characteristics of young women with stage Ⅰa2 to Ⅱa2 cervical cancer by using multi-center data of cervical cancer in China. Methods: The clinicopathological data of 46 313 patients with cervical cancer treated from 37 hospitals in China were obtained from January 2004 to December 2016. Using clinical and pathologic data, each patient's stage was reclassified by the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system. A total of 19 041 patients were selected according to the following criteria: FIGO stage Ⅰa2 to Ⅱa2, underwent type B or C radical hysterectomy and pelvic lymphadenectomy. All the patients were divided into two groups: the study group of 1 888 patients aged 35 years or younger and the control group of 17 153 patients aged over 35 years. The 13 years trend in proportion of young women with stage Ⅰa2 to Ⅱa2 cervical cancer, risks factors and clinicopathological characteristics of two groups were retrospectively analyzed. Results: (1) The total number of hospitalized patients with stage Ⅰa2 to Ⅱa2 cervical cancer increased annually. However, a downward trend of patients aged 35 years or younger was observed (P<0.01) . The constituent ratio of patients aged 35 years or younger was significantly greater during 2004-2010 than that during 2011-2016 [12.6% (820/6 484) and 8.5% (1 068/12 557) , respectively; χ(2)=82.101, P<0.01]. (2) Compared with patients aged over 35 years, patients aged 35 years or younger had an earlier age at menarche, a later age at marriage, lesser gravida and parity (all P<0.01). The positive rate of high-risk HPV infection was not statistically different between two groups (all P>0.05). (3) The proportions of stage Ⅰ, exophytic type and non-squamous histological type in patients aged 35 years or younger were clearly higher than those in patients aged over 35 years (83.4% vs 68.5%, P<0.01; 63.2% vs 56.2%, P<0.01; 13.9% vs 12.0%, P<0.05, respectively). Whereas the poor differentiation ratios of the two groups had no statistical significance (P>0.05). (4) As for the postoperative pathological risk factors, the rate of surgical margin involvement in patients aged 35 years or younger was lower than that aged over 35 years (1.1% vs 1.8%, P<0.05), and the rate of depth of stromal invasion >1/2 in patients aged 35 years or younger was lower than that in patients aged over 35 years (40.1% vs 50.9%, P<0.01). In addition, there were no significant difference in parametrial margin involvement, tumor size and lymph vascular space invasion between two groups (all P>0.05). Conclusions: The trend in proportion among hospitalized patients for stage Ⅰa2 to Ⅱa2 cervical cancer in young women is decreasing yearly. Compared with cervical cancer in middle-aged and elderly women, cervical cancer in young women have an earlier age at menarche, a higher proportion of stage Ⅰ patients and non-squamous histological type. In terms of the postoperative pathological risk factors, the rate of surgical margin involvement and depth of stromal invasion >1/2 in young women with cervical cancer are lower than in middle-aged and elderly women.

[The dynamic change of cytokines associated with the speccificimmunotherapy and its clinical significance].

Objective:This project aimed to study the dynamic change of the cytokines associated with specific immunotherapy(SIT) pre- and post-SIT.Searching for immune regulatory indicators would used in SIT.Method:One hundred cases who had accepted SIT were enrolled in the project.Data of serum specific IgE and cytokines were statistically analyzed.In the three periods,pre-SIT,17 weeks post-SIT,57 weeks post-SIT,the levels of the eight kinds of cytokines(IL-4,IL-5,IL-8,IL-10,IL-13,IL-17,IFN-γ and TNF-α)were detected,and the dynamic change of the nasal symptoms score were analyzed.Result:The six kinds of cytokines(IL-5,IL-8,IL-10,IL-13,IL-17 and TNF-α)had no significant difference before and after SIT.The level of house dust mite sIgE level was positively correlated with serum IL-5 when the SIT pre-treatment and 57weeks (P<0.05).Pre-treatment and in 17 weeks after treatment,serum IL-5,IL-17 content difference and reduce the magnitude of nasal symptom scores were positively correlated (P<0.01).In 17 weeks of treatment and 57 weeks of treatment,difference of serum IL-10,IL-13,TNF-α levelsand the difference of nasal symptom scores were negatively correlated(P<0.01).Pre- treatment and 57 weeks,difference of serum IL-13,IL-17,TNF-α and the difference of nasal symptom scores were positively correlated (P<0.05),serum IL-10 levels of difference between the nose ministry of magnitude lower symptom scores were negatively correlated (P<0.01).Conclusion:The cytokines (IL-4,IL-5,IL-8,IL-10,IL-13,IL-17,IFN-γ and TNF-α) associated with the SIT play an important role in allergy and can objectively reflect the immune status during SIT.