43例术后病理提示子宫内膜癌患者的病例资料分析  

Analysis of case data of 43 patients with postoperative pathological indications of endometrial cancer

作　　者：何素丽 孙茹 刘海燕 He Suli;Sun Ru;LiuHaiyan(Department of Obstetrics and Gynecology,Affiliated Hospital of Yangzhou University,Yangzhou 225003,China)

机构地区：[1]扬州大学附属医院妇产科,江苏扬州225003

出　　处：《实用妇科内分泌电子杂志》2023年第22期1-3,17,共4页Electronic Journal of Practical Gynecological Endocrinology

基　　金：2021年度江苏省妇幼健康科研项目(编号F202134)。

摘　　要：目的分析43例术后病理提示子宫内膜癌患者的病例资料。方法收集并分析43例术前、术后诊断不一致而术后病理提示子宫内膜癌患者的临床病例资料,包括年龄、绝经与否、术前诊断方式、治疗等。结果43例患者平均年龄为56.23岁;绝经20例(46.5%),未绝经23例(53.5%);症状:异常子宫出血33例(76.7%),下腹痛伴或不伴阴道排液5例(11.6%),内膜增厚2例(4.7%),其他3例(7.0%);术前内膜厚度:内膜厚度>4 mm 36例(83.7%),内膜厚度≤4 mm 4例(9.3%),未进行相关检查3例(7.0%);手术方式:全子宫双附件切除术32例(74.4%),全子宫双输卵管切除术3例(7.0%),全子宫切除术4例(9.3%),全子宫双附件切除术+盆腔淋巴结清扫术1例(2.3%),全子宫双附件切除术+盆腔淋巴结腹主动脉旁淋巴结清扫术+大网膜阑尾切除术3例(7.0%);肿瘤分化程度:高分化12例(27.9%),中分化27例(62.8%),低分化4例(9.3%);组织病理学类型:子宫内膜样癌40例(93.0%),非子宫内膜样癌3例(7.0%);特殊病史:乳腺癌病史1例(2.3%),结肠癌病史1例(2.3%),贲门癌及内膜癌家族史1例(2.3%),高血压8例(18.6%),糖尿病4例(9.3%)。14例患者进行术前诊刮术,16例患者进行术前宫腔镜诊刮术,13例患者直接手术,术后3例患者补充手术治疗,9例患者补充放化疗。结论对于有异常子宫出血的围绝经期或绝经后女性,病理提示子宫内膜非典型增生者,仍需警惕子宫内膜癌可能性。Objective To analyze the case data of 43 patients with postoperative pathological indications of endometrial cancer.Methods Collect and analyze clinical case data of 43 patients with inconsistent preoperative and postoperative diagnoses and postoperative pathological indications of endometrial cancer,including age,menopausal status,preoperative diagnostic methods,treatment,etc.Results The mean age of the 43 patients was 56.23 years old.There were 20 cases(46.5%)after menopause and 23 cases(53.5%)before menopause.Symptoms:Abnormal uterine bleeding in 33 cases(76.7%),lower abdominal pain with or without vaginal drainage in 5 cases(11.6%),endometrial thickening in 2 cases(4.7%)and other 3 cases(7.0%);Preoperative intima thickness:36 cases(83.7%)had an intima thickness>4 mm,4 cases(9.3%)<4 mm,and 3 cases(7.0%)did not undergo relevant examination.Surgical method:Total double adnexectomy of uterus was performed in 32 cases(74.4%),total double salpingectomy of uterus in 3 cases(7.0%),total hysterectomy in 4 cases(9.3%),total double adnexectomy of uterus plus pelvic lymph node dissection in 1 case(2.3%).Total hysterectomy with double adnexa,pelvic lymph node dissection with paraaortic lymph node dissection and greater omental appendectomy were performed in 3 cases(7.0%).The degree of tumor differentiation was highly differentiated in 12 cases(27.9%),moderately differentiated in 27 cases(62.8%)and poorly differentiated in 4 cases(9.3%).Histopathological types:endometrioid carcinoma 40 cases(93.0%),non-endometrioid carcinoma 3 cases(7.0%);Special medical history:1 case of breast cancer(2.3%),1 case of colon cancer(2.3%),1 case of cardial and endometrial cancer family history(2.3%),8 cases of hypertension(18.6%),4 cases of diabetes(9.3%).Preoperative curettage was performed in 14 patients,hysteroscopic curettage was performed in 16 patients,direct surgery was performed in 13 patients,supplementary surgery was performed in 3 patients,and supplementary chemoradiation was performed in 9 patients.Conclusion For perimenopausal o

关 键 词：病理 子宫内膜癌 子宫内膜非典型增生 诊刮 宫腔镜 

分 类 号：R737.33[医药卫生—肿瘤]