子宫内膜癌合并子宫肌瘤或(和)子宫腺肌病临床病理分析  

Clinical and Pathological Analysis of Endometrial Cancer Coexisting with Uterine Myoma or(and)Adenomyosis

作　　者：刘宋宋[1] 张虹[2] 杨超[1] 

机构地区：[1]天津医科大学,300070 [2]天津市中心妇产科医院

出　　处：《国际妇产科学杂志》2013年第2期187-190,共4页Journal of International Obstetrics and Gynecology

摘　　要：目的:分析子宫内膜癌合并子宫肌瘤或(和)子宫腺肌病患者的临床病理特征,比较合并子宫肌瘤或(和)子宫腺肌病的子宫内膜癌与单纯子宫内膜癌的高危因素情况。方法:回顾性分析天津市中心妇产科医院2010年8月—2012年3月收治的298例子宫内膜癌患者的临床病理资料,其中合并子宫肌瘤者106例(35.6%,A组),合并子宫腺肌病者37例(12.4%,B组),同时合并子宫肌瘤与子宫腺肌病者48例(16.1%,C组),单纯子宫内膜癌者107例(35.9%,D组)。结果:A组、C组比D组的手术-病理分期早(Zc分别为2.10和2.06),肌层浸润浅(Zc分别为1.99和2.23),雌激素受体(ER)、孕激素受体(PR)阳性检测率高(χ2分别为10.83、5.78;7.75、4.13),差异均有统计学意义(均P<0.05),A组、B组比D组的组织分化好(Zc分别为2.18和2.01),B组PR阳性检出率高于D组(χ2=3.86),差异有统计学意义(均P<0.05),其他指标与D组比较差异无统计学意义(均P>0.05)。而A组、B组和C组间比较差异无统计学意义(均P>0.05)。4组间的腹水细胞学阳性、淋巴结转移、病理类型比较差异无统计学意义(均P>0.05)。结论:子宫内膜癌合并子宫肌瘤多属雌激素依赖性肿瘤,组织分化好,肌层浸润浅,高危因素较少。单纯性子宫内膜癌高危因素较多。Objective：To analyze the clinical and pathological characteristics of patients of endometrial cancer coexisting with uterine myoma or（and） adenomyosis, and compare the high risk factors between endometrial cancer with uterine fibroids or （and） adenomyosis and pure endometrial cancer. Methods：The clinical and pathological data of 370 patients with endometrial carcinoma hospitalized to Tianjin Central Hospital of Gynecology Obstetrics from August 2010 to March 2012 were retrospec- tively analyzed. Patients were divided into merger uterine myoma group （group A, 35.6% ）, merger adenomyosis group （group B, 12.4% ）, merger uterine myoma and adenomyosis group （group C, 16.1% ）, pure endometrial cancer group （group D, 35.9% ）. Results：GroupA, C are more early in clinie-pathologic staging （Z c=2.10,2.06）, more superficial in myometrium invasion （Zc= 1.99,2.23）, more well in tissue differentiation （Zc=2.18）, higher in ER, PR tested positive rate （X2= 10.83,5.78 ; 7.75,4.13 ） than group D,and all differences have statitical significance （P〈0.05）. Group B is more well in tissue differentiation （Zc=2.01）, higher in PR tested positive rate （A3=3.86） than group D, and differences have statitical significance （P〈 0.05 ）. While the other factors has no significancy compareed with group D;and there was no significant difference in groupA, B and C （P〉0.05）. The peritoneal cytology,lymph node metastasis and pathological type showed no signifiicant difference among the four groups （P〉 0.05）. Conclusions ：Endometrial carcinoma combined with uterine myoma mostly belongs to an estrogen-dependent tumor, with well-differentiated tissue and superficial myometrial invasion,with less high risk factors. While pure endometrial cancer mostly with more high risk factors.

关 键 词：子宫内膜肿瘤 子宫肿瘤 平滑肌瘤 子宫疾病 病理学 临床 回顾性研究 

分 类 号：R737.33[医药卫生—肿瘤]