90例子宫内膜癌腹腔液细胞学检查及随访  

Peritoneal washing cytology and follow-up survey in 90 cases of endometrial carcinoma

作　　者：郭华伦[1] 刘明圭[1] 李诚信[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：《中国实用妇科与产科杂志》2000年第6期352-354,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　探讨腹腔液细胞学检查在子宫内膜癌手术病理分期与预后的意义。方法　对 1989年 1月至1995年 12月收治的临床Ⅰ、Ⅱ期且经手术治疗并术中行腹腔液常规细胞学检查的 90例子宫内膜癌临床与随访资料进行回顾分析。结果　 90例术中腹腔液常规细胞学阳性检出率为 12 2 2 % (11/ 90 ) ,其中Ⅰ期占 8 33 % ,Ⅱ期占 2 7 2 7%。 11例细胞学阳性中 7例分别于术后 2～ 2 6个月内死于癌瘤。术中腹腔液脱落肿瘤细胞染色体细胞学阳性检出率为 2 1 11% (19/ 90 )。 11例常规细胞学阳性者染色体细胞学全部阳性 ,而 3例染色体细胞学阳性常规细胞学阴性者因癌死亡。 90例临床分期Ⅰ、Ⅱ期子宫内膜癌 5年累积存活率为 79 6 9% ,72例手术分期Ⅰ、Ⅱ期内膜癌累积存活率 89 2 2 % (Kaplan -Meire法 ) ,两种分期法累积存活率比较有显著性差异 (P <0 0 5 )。 结论　手术分期法优于临床分期法 ,其中 ,腹腔液常规细胞学检查对子宫内膜癌的分期、指导治疗。Objective\ To investigate the value of peritoneal washing cytology(PWC)in operative-pathological staging and prognosis of endometrial carcinoma.Methods\ Informations of clinic and follow-up were analysed retrospectively,in 90 endometrial carcinoma,clinical stage Ⅰand Ⅱ,undergoing surgical operations and PWC from Jan.1989 to Dec.1995 Results\ The positive rate of PWC were 12 22%(11/90)for overall,in which there was 8 33% for clinical stage Ⅰ,and 27 27% for clinical stage Ⅱ.Of 11 PWC-positive cases,7 died of cancer within 2 to 26 months after operation.By peritoneal washing chromasome-cytology(PWCC),the cancer cell detection rate was 21 11%(19/90).All the PWC-positive cases were also found PWCC-positive(11/11).3 PWCC-positive cases with negative PWC died of cancer.The accumulated 5-year survival rate of 90 clinical stage ⅠandⅡ patients was 76 69%,while that of 72 operative stage ⅠandⅡ was 89 22%(Kaplan-Meire method).The difference was very significant(P<0 05).Conclusion\ Operative staging is superior to clinical staging.PWC is of great importance to staging,guiding treatment and prognosis of endometrial carcinoma.

关 键 词：子宫内膜癌 细胞学 手术分期法 腹腔液 

分 类 号：R737.33[医药卫生—肿瘤]