子宫内膜癌149例临床及随访资料回顾分析  

Retrospective analysis of clinical and follow-up results in 149 cases of endometrial carcinoma

作　　者：郭华伦[1] 李诚信[1] 刘明圭[1] 邓克华[1] 罗兵[1] 李汉萍[1] 

机构地区：[1]江西省妇幼保健院,南昌330006

出　　处：《江西医药》2000年第1期3-6,共4页Jiangxi Medical Journal

摘　　要：目的　探讨影响早期子宫内膜癌疗效的有关问题。方法　回顾分析 1989年 1月至 1995年 12月我院收治并经手术治疗的临床Ⅰ、Ⅱ期子宫内膜腺癌 14 9例临床及随访资料。结果　临床分期法Ⅰ、Ⅱ期子宫外转移率 15 .4 4%、累积生存率80 .3 5 % ,与手术分期法比较差异显著 (P <0 .0 5 ) (Kaplan -meier) ;手术分期法Ⅰc 期转移、癌亡率在 15 .0 0 % ;腹腔细胞学阳性检出率 12 .2 2 % ,腹腔肿瘤脱落细胞染色体核型分析阳性检出率 2 1.11%。结论　临床分期法难以反映Ⅰ期癌子宫外转移及发生不良预后的原因 ,手术分期法则更具合理性 ;Ⅰc 期应行次广泛子宫根治术加盆腔及腹主动脉旁淋巴清扫 /采样术 ;腹腔细胞学检查对分期、预后估价、指导治疗均具重要意义 ,应作为本病术前的常规检查内容 ,而染色体细胞学则有较好的敏感性 ,临床意义有待研究。Objective To evaluate the prognostic factors relating to the treatment of early endometrial carcinoma.Methods The clinical and follow-up results were analyzed retrospectively in 149 cases of endometrial carcinoma,preoperative clinical stage Ⅰ andⅡ from Jan.1989 to Dec.1995.Results In the clinic stage Ⅰ and Ⅱ,the extra-uterine metastasis vate was 15.44%,the accumulative surviral rate 80.35% was significantly lower than that in the surgical stage Ⅰ and Ⅱ(P<0.05,Kaplan-Meier wethod).In surgical stage Ic,15% were found with metastasis and /or death from cancer.In peritoneal washing examination,12.22% of cases had positive cytology,and 21.11% of chromosome examination were positive.Conclusion It is difficult to reflect extra-uterine metastaese and the bad prognoses in stage Ⅰ by clinical staging system.The surgical-pathological staging system can more arailably reflect the lesion extent of endometrial carcinoma.It is advised,at least,to perform modified radical hysterectomy and resection of pelvic and paraaortic lymphnodes be performed in stage Ic cancer.The peritoneal washing cytology is valuable in staging,prognosis and guiding treatment,and should be routinely performed prior cancer resecting.Chromosome examination has shown a higher sensitivity than cytology,it's clinical value should be worthy to be study.

关 键 词：子宫内膜癌 诊断 治疗 

分 类 号：R737.33[医药卫生—肿瘤]