최근 20년간 여성 생식기 암 발생 양상의 변화

Abstract

This study was based on all female genital malignancies with the except of trophoblastic disease which reported to the Keimyung University Dongsan medical center between 1975 and 1994. We evaluated the changing trends of the incidence and histopathology of the female genital malignancies by comparing the two time periods (1975∼1984, 1985∼1994). In the first ten years, 2,172 cases (2.9%) were registered and in the second ten years, 2,306 cases (2.9%) were registered. There were no statistically differences in the general frequencies. In the period from 1975 to 1984, the average frequency of cervical cancer was 93.4%, ovarian cancer followed with 2.4%, uterine corpus with 1.6%, vulvar and vaginal with 1.2%, tubal with 0.1%. In the period from 1985 to 1994, cervical cancer accounted for 86.0% of all cancer cases, ovarian cancer for 6.3%, corpus cancer for 3.6%, vulvar and vaginal for 2.1%, tubal for 0.1%. During the twenty years period, the frequency of cervical cancer decreased and the incidence of corpus and ovarian cancer increased. The most frequent histologic type of the cervical cancer was squamous cell carcinoma, and followed by adenocarcinoma. Adenocarcinoma of the cervix showed a gradual increase in incidence (5.0% in 1975∼1984, 8.2% in 1985∼1994). According to invasiness of the cervix, the frequency of cervical intraepithelial neoplasm was increased when compairing the second ten years (38.4%) with the first ten years (25.7%). The peak age incidence of cervical cancer was noted between 40∼49 years in the first ten years and also noted between 50∼59 years in the second ten years. Based on the FIGO staging system for cervical cancer, stage Ⅱ was most frequent during first ten years and stage Ⅰ was most frequent during the second 10 years. There were no frequency changes noted in stage Ⅲ or Ⅳ during study period. Ovarian cancer was the second most common malignancy and gradually increased with incidence. The peak age was 6 th' decade during twenty years. According to histologic subtype, an epithelial ovarian tumor was most frequent. Corpus cancer was the third most common malignancy and specially, endometrial cancer. The peak age between 50∼59 years during the study period.

계명대학교 동산의료원 산부인과학교실을 내원한 환자에서 1975년부터 1994년까지 융모성 질환을 제외한, 조직학적으로 여성 생식기 침윤암으로 확인된 4,487예를 조사하였다. 1975년부터 1984us까지의 전 10년에는 침윤암이 2,172명(2.9%), 이후 1985∼1994년까지는 2,306명(2.9%)로 빈도 수는 차이가 없었다. 자궁경부암은 전반기 10년간은 전체의 93.4%, 후반기에는 86.0%로 감소를 보였으며, 병리조직학적으로는 전 10년에는 편평상피암이 1,928명(95.3%) 선암이 101명(5.0%)이었고, 후 10년에는 편평상피암 1821명(91.8%), 선암이 163명(8.2%)로 선암발생이 증가하였다. 자궁경부 상피내종양과 침윤암의 빈도는 전 10년에는 703명(25.7%)이었으나 후 10년에는 1235명(38.4%)로 현저한 증가가 있었다. 연령별 분포는 전 10년간에는 40∼49세에 가장 많았고, 후 10년에는 50∼59세에 가장 많은 분포를 차지하였다. 임상기별 분포는 전 10년에는 Ⅱ기가 가장 많았고 후 10년에는 Ⅰ기가 가장 많았으나, Ⅲ, Ⅳ기의 빈도는 변화가 없었다. 난소암은 두 번째로 많았으며 전 10년에는 2.4%, 후 10년에는 6.3%로 점차 증가하는 양상이었다. 조직학적으로는 상피성 난소암이 가장 많았으며 전 10년 및 후 10년에서 39예(73.6%) 및 110예(75.9%)이었다. 연령 분포는 전 10년 및 후 10년에서 50∼59세에 가장 많은 분포를 보였다. 자궁체부암은 주로 자궁내막암이었고 전체 여성암 중 에서 전 10년은 1.6%, 후 10년은 3.6%로 증가 추세를 보였 다. 연령별 추이는 50∼59세에 가장 높은 분포를 보였다. 질암은 전 10년에 0.9%, 후 10년에는 1.3%로 증가 추 세를 보였고, 연령별 분포는 50∼59세에 가장 많았다.