老年子宫内膜癌患者的临床病理研究  

Clinical and pathological analysis of elderly patients with endometrial carcinoma

作　　者：燕鑫[1] 安娜[1] 高敏[1] 蒋国庆[1] 高雨农[1] 

机构地区：[1]北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所妇科,100036

出　　处：《中华老年医学杂志》2008年第2期107-110,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨老年子宫内膜癌患者的临床病理特点、治疗方法和预后。方法回顾性分析57例年龄60-87岁的子宫内膜癌患者（老年组）和28例25～45岁子宫内膜癌患者（非老年组）的临床和病理资料。结果与非老年组比较，老年组患者的孕次多、产次多、体质指数高，伴有与子宫内膜癌发病相关并存疾病的患者多，症状出现后就诊时间早，差异有统计学意义（均为P〈0．05）。老年组IC～1V期患者37例（64．9％），非老年组11例（39．3％），二者比较差异有统计学意义（P〈0．05）。两组均以I型子宫内膜癌为主，宫颈浸润、卵巢转移、腹腔冲洗液阳性率、雌激素受体阳性率及淋巴结阳性率比较，差异无统计学意义（均为P〉0．05）。老年组的组织分化以中分化为主，占47．7％，非老年组以高分化为主，占57．1％；老年组的深肌层浸润为49．1％，非老年组为21．4％，差异有统计学意义（均为P〈0．05）。两组患者的手术方式、失血量、手术并发症、术后辅助放化疗或激素治疗比较，差异无统计学意义（均为P〉0．05）。老年组的复发率为24．6％，非老年组为10．7％，差异无统计学意义（P〉0．05）。老年组3年和5年生存率分别为80．6％和64．7％，低于非老年组（分别为95．8％和87．9％），两组比较，差异无统计学意义（P〉0．05）。结论老年子宫内膜癌患者肥胖者多，多为IC期以上的I型中分化子宫内膜癌；虽然并存疾病多，但未影响老年患者接受手术治疗及术后辅助治疗，预后与非老年子宫内膜癌患者相似。Objective To explore the clinical and pathological characteristics, diagnosis, treatment and prognosis of elderly patients with endometrial carcinoma. Methods Retrospectively analyzed the clinical/pathological features of 57 elderly patients（≥60 years） （older group） and 28 non -elderly patients（≤45 years） （younger group） with endometrial carcinoma. Results Compared with the younger group, the older group had more pregnancies, more paras, higher body mass index, more endometrial cancer-related comorbidities and shorter time interval from ill to come to hospital（all P〈 0. 05）. The 2 groups had mainly type I endometrial cancer. There were no statistically differences in the cervical invasion, ovarian transplantation, positive peritoneal cytology, positive estrogen receptor and positive lymph node between the 2 groups （all P〉0.05）. There were 37 cases （64.9%） with surgical-pathological stage ≥ I C in the older group, while in the younger group were 11 cases （39. 3%）, （P%0.05）. The histological grade in the older group was mainly G2 （47.7%）, while in the younger group was G1 （57.1%） （P%0.05）. The deeper myometrial invasion in the older group was 49. 1%, and 21.4% in the younger group （P〈0.05）. There were no statistically differences in the style of operation, blood loss, operation-related complications, ajunctive therapy after operation and the recurrent rate （all P〉0.05）. The 3 year and 5 year overall survival rate in the older group were 80.6% and 64.7%, while in the younger group were 95.8% and 87.9%, respectively （P〉 0.05）. Conclusions Compared with the younger endometrial cancer patients, the pathologic type of the older patients mainly is type I , and the histological grade is mainly G2, the surgical-pathological stage is stage I C and later. Although the older patients have more complications, there are no differences in the operation range and the ajunctive therapy after operation, and the prognosis is not worse than the younger patien

关 键 词：子宫内膜肿瘤 病理 临床 

分 类 号：R737.33[医药卫生—肿瘤] R735.2[医药卫生—临床医学]