임신과 합병된 자궁경암에 관한 임상적 고찰

Abstract

[한글]

자궁경암은 한국인에 있어서, 전체 악성종양의 16.8%∼44.0%이며, 여성에서 발생하는 악성종양의 27.2%∼68.2%로 발생빈도가 높다.

자궁경암이 임신과 합병되는 경우는 희귀한, 진단 및 치료에서 태아와 모체의 안전과 건강을 고려해야 하기 때문에, 임신을 합병한 자궁경암은 산부인과 영역에서 중요한 것이다.

본 교실에서는 1959년 2월부터 1964년 8월말까지 만 5년 7개월간, 임신을 합병한 자궁경암에 관하여 임상적으로 관찰한 바 있거니와, 다시 1964년 9월부터 1977년 7월까지 만 12년 11개월간, 연세대학교 의과대학부속 세브란스병원 및 원주기독병원 산부인과에 입원하였던 임신을 합병한 자궁경암환자 26예를 대상으로 하여, 연대적 차이에 따른 임상적 차이에 역점을 두어 연구하였다.

[영문]

Carcinoma of the cervix is the most common malignant tumor in women in Korea, but it is infrequently associated with pregnancy.

Carcinoma of the cervix during pregnancy has been the subject of considerable discussion and contradiction as to behavior, incidence and treatment and the diagnosis of cervical cancer during pregnancy is uncommon. Certainly early diagnosis followed by immediate and adequate therapy is most important. For this

object, routine cervical smear should be examined in all pregnant women. There are few reports in cervical cancer during pregnancy in Korea. We observed cervical cancer in pregnancy 12 years ago (1959.2-1964.8) For further evaluation of cervical cancer during pregnancy, we studied 26 cases of cervical cancer associated with

pregnancy in the Department of Obsterics and Gynecology, Severance Hospital and Wonju Christian Hospital during the period from Sep. 1, 1964 to Jul. 31, 1977.

The results obtained were as follows;

1) The incidence of cervical cancer in pregnant women was 1:1110 (0.09%) and the incidence of pregnancy in cervical cancer patients was 1:69(1.43%).

2) Age distribution of cervical cancer during pregnancy was 31 to 45 years and the average age was 37.7 years.

3) Average parity was 4.28.

4) Contact bleeding was encountered in 17 cases and an asymptomatic course in 2 cases.

5) Cervical smear as a screening procedure was performed in 24 cases, and 22 cases(91.4%) were more than Class Ⅲ.

6) According to motivation of diagnosis, referal to our clinic was made in 12 cases.

7) Time of diagnosis was 1st trimester-11 cases, 2nd trimester-9cases, 3rd trimester-2 cases and postpartum-4 cases.

8) According to the clinical stage, the results showed stage 0-6 cases, stage Ⅰ-7 cases, stage Ⅱ-9 cases, stage Ⅲ-2 cases and stage Ⅳ-2 cases.

9) External irradiation and intracavitary irradiation were done in 15 cases (75.0%) and radical abdominal hysterectomy with pelvic lymphadenectomy was done in 4 cases of invasive carcinoma of the cervix.

10) The result of follow up was poor because many cases were lost after hospital discharge.