子宫乳头状浆液性癌29例临床病理分析  

Clinical and pathological analysis of 29 uterine papillary serous carcinoma

作　　者：马莹[1] 白萍[1] 马绍康[1] 冯晓莉[2] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院妇瘤科,北京100021 [2]中国医学科学院中国协和医科大学肿瘤医院病理科,北京100021

出　　处：《中国实用妇科与产科杂志》2008年第3期201-203,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的通过对子宫乳头状浆液性癌(UPSC)临床病理特征的分析,探讨合理的治疗方法。方法回顾性研究1994年1月至2006年9月中国医学科学院肿瘤医院收治的29例UPSC。结果29例中,3例单纯放疗,5例外院手术,全面手术分期21例,其中Ⅲ、Ⅳ期患者占81.0%(17/21)。术前诊刮确诊率:47.6%,术后病理纯型占69.2%,混合型占26.9%,息肉型占3.8%,深肌层浸润占45.0%(9/21),腹膜后淋巴结转移率56.3%(9/16),大网膜转移率33.3%(4/12)。92.3%(24/26)的患者术后接受化疗,34.6%(9/26)的患者术后接受化疗+放疗。Ⅲ期、ⅣB期3年总存活率分别为64.8%、53.3%,5年总存活率分别为43.2%、0。单因素分析显示腹膜后淋巴结转移(P=0.014)、术中残存肿瘤(P=0.013)、辅助术后放疗(P=0.021)与预后有关,多因素分析显示仅术中残存肿瘤与预后有关(P=0.042)。结论子宫乳头状浆液性癌恶性程度高,预后差,诊断时晚期病例占大多数,强调手术应行全面的分期和最大限度的减瘤术,术后放疗可改善预后。Objective To study the clinical and pathological characteristics and rational therapy for uterine papillary serous carcinoma（UPSC）. Methods A total of 29 patients with pathologically confirmed UPSC from Jan. 1994 to Sep. 2006 were retrospectively analyzed. Results Of 29 cases, 3 received simple radical radiotherapy, 5 underwent operation in other hospitals,and 21 underwent surgical staging in our hospital. Advanced cases were 81.0%. The rate of diagnosis in pre-operation was 47.6%, pure UPSC were seen in 69. 2%, mixed were 26. 9% and polypoid were 3. 8% ; about 45.0% （9/21） had deep myometrial invasion, 56. 3% （9/16） had pest-peritoneum lymphnode metastasis, and 33. 3% （4/12） had omentum metastasis. About 92. 3% （24/26） received postoperative adjuvant chemotherapy, 34. 6% （9/26） received postoperative chemotherapy followed by radiotherapy. The three-year and five-year overall survival for stage III was 64. 8% and 53.3%, and for stage 1gs ,43.2% and 0, respectively. Patients with post-peritoneum lymphnode metas- tasis, residual tumor, and postoperative radiotherapy were associated with prognosis by univariate analysis （ P 〈 0. 05 ）, while in a multivariate analysis only residual tumor was significantly different （ P 〈 0. 05 ）. Conclusion Most patients are in advanced stages at diagnosis and have a poor prognosis. Complete surgical staging and maximal resection should be recommended. Postoperative adjuvant radiotherapy can improve prognosis.

关 键 词：子宫内膜肿瘤 癌 浆液性 

分 类 号：R71[医药卫生—妇产科学]