Ⅱ期子宫内膜癌临床处理进展  

Advances in Clinical Management of Stage Ⅱ Endometrial Cancer

作　　者：张天宇[1] 王益勤 王建六[1] ZHANG Tian-yu;WANG Yi-qin;WANG Jian-liu(Peking University People′s Hospital, Beijing 100044, China)

机构地区：[1]北京大学人民医院,北京100044

出　　处：《国际妇产科学杂志》2017年第4期390-395,共6页Journal of International Obstetrics and Gynecology

基　　金：国家科技支撑计划(2015BAI13B00)

摘　　要：Ⅱ期子宫内膜癌的发生率约占子宫内膜癌的12%,诊断Ⅱ期子宫内膜癌可将分段诊刮、宫腔镜检查及影像学相结合以提高分期诊断的准确性。目前对于Ⅱ期子宫内膜癌术式的选择存在争议,不同研究得出的结论不同,扩大切除范围降低复发率的同时也增加了术中和术后并发症,对此,需要仔细权衡,并需要更多的前瞻性研究进一步加以评估。术后放疗能够减少局部复发率,但对总生存率没有影响,其中阴道近距离放疗可能优于全盆腔放疗。对于合并高危因素者选择辅助化疗的生存率高于放射治疗。Ⅱ期子宫内膜癌的3年生存率为79%~85%。对Ⅱ期子宫内膜癌[2009年国际妇产科联盟(FIGO)分期]的临床特征、诊断方法、治疗及预后进行综述。The incidence of stageⅡendometrial cancer accounts for about12%of endometrial cancer.The combination of the dilationand curettage,hysteroscopy and the imaging technique is a good choice for diagnosis.At present,the surgical approach of stageⅡendometrial cancer is controversial,different studies have come to different conclusions,to expand the resection range to reduce the recurrence rate also increased intraoperative and postoperative complications.We should carefully balance the benefits of prognosis and increasing risk of surgery in selecting the surgical range.More prospective experiments are needed.Postoperative radiotherapy can reduce the recurrence rate,but have no effect on the overall survival rate.And vaginal brachytherapy may be better than pelvic radiotherapy.Adjuvant chemotherapy is needed in high-risk stageⅡendometrial cancer.The three year survival rate of stageⅡendometrial cancer is79%-85%.The diagnosis,treatment and prognosis of stageⅡendometrial cancer,which is the endometrial cancer patients with cervical stromal involvement[new International Federation of Gynecology and Obstetrics(FIGO)stageⅡ]are reviewed.

关 键 词：子宫内膜肿瘤 肿瘤分期 诊断 治疗 预后 

分 类 号：R737.33[医药卫生—肿瘤]