绝经后子宫内膜癌癌周内膜病理学特征及其与预后的关系  

The Relationship between the Pathologic Features of the Uninvolved Endometrium and Prognosis in Postmenopausal Endometrial Carcinoma

作　　者：王丽[1] 周先荣[1] 杜心谷[1] 

机构地区：[1]上海医科大学妇产科医院病理科

出　　处：《中华妇产科杂志》1997年第10期605-608,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的：研究绝经后子宫内膜癌癌周内膜的病理学特点及其与预后的关系。方法：根据癌周内膜的组织学表现分为增生型和萎缩型两组，对２０４例子宫内膜癌患者的临床与病理特点和长期随访结果进行回顾性分析。结果：癌周内膜呈增生型的子宫内膜癌患者伴发高血压、肥胖、糖尿病、不孕及子宫内膜增生过长史的机率显著高于癌周内膜呈萎缩型的子宫内膜癌患者（Ｐ＜０．００１）；具有较高恶性程度的非内膜样腺癌（包括透明细胞型腺癌、鳞腺癌、浆液型腺癌）在癌周内膜呈萎缩型组占２７．０％，在增生型组占５．５％（Ｐ＜０．００１）。癌周内膜呈萎缩型者较增生型者呈低分化倾向及深肌层、脉管浸润（Ｐ＜０．００１）；５年生存率，癌周内膜呈增生型子宫内膜癌患者为９６．７％，萎缩型为８６．２％（Ｐ＜０．０１）。结论：子宫内膜癌癌周内膜的病理学特征与预后相关，癌周内膜呈增生型者的预后好于萎缩型。Objective: To investigate the relationship between the pathologic features of the uninvolved endometrium and prognosis in postmenopausal endometrial carcinoma. Method: The clinico pathologic features of 204 cases of endometrial carcinoma were analyzed retrospectively, according to the proliferative and atrophic uninvolved endometrium, a long term follow up was done. Results: The patients with proliferative uninvolved endometrium (PUE) were more much related with the clinical risk factors than those of atrophic uninvolved endometrium (AUE) ( P <0.001). AUE cases had more virulent types of nonendometrial carcinoma than those of PUE (27% vs 5.5%, P <0.001), and had much worse grade, much deeper myometrial invasion and much vascular invasion ( P <0.001). The overall 5 year survival rate was 96.7% in the PUE cases and 86.2% in the AUE cases ( P <0.01). Conclusion: The histopathologic types of the uninvolved endometrium were related to the prognosis of the patients with endometrial carcinoma. The patients with proliferative uninvolved endometrium had better prognosis than those with atrophic uninvolved endometrium.

关 键 词：子宫内膜肿瘤 腺癌 预后 绝经 病理学 

分 类 号：R737.33[医药卫生—肿瘤]