子宫内膜癌介入治疗前后癌组织的病理学改变  

Pathologic changes of endometrial carcinoma after interventional chemotherapy

作　　者：陈春林[1] 刘萍[1] 马奔[1] 梁立治[2] 杜洪[1] 刘佩鸣[1] 谭道彩[2] 

机构地区：[1]广州市第一人民医院妇产科介入中心,510180 [2]中山医科大学肿瘤医院妇科,广州510089

出　　处：《中国实用妇科与产科杂志》2003年第7期417-419,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　探讨子宫内膜癌介入治疗 (盆腔动脉灌注化疗栓塞 )前后的病理学改变。方法　对 1991年 3月至 2 0 0 2年 10月 9例子宫内膜癌患者实施术前介入治疗 ,抗癌药物选择CBP、ADM或EPI ;全部病例在灌注化疗(2 /3量抗癌药物 )后 ,用携带有抗癌药物 (1/3量 )的KMG或明胶海绵颗粒栓塞子宫动脉或髂内动脉。结果　9例子宫内膜癌中 7例在行 1～ 2疗程的介入治疗后实施手术治疗 ,其中 5例术后标本病理切片中可见大量坏死组织及淋巴细胞浸润 ,未见癌细胞 ,组织学完全缓解 (HCR) ;1例癌细胞绝大部分坏死仅见极少数残存变异的癌细胞 ,1例癌组织部分坏死 ,1例Ⅳ期的患者在 2次介入治疗后失去手术机会 ,1例Ⅳ期患者在阴道出血成功止血后 4 6天死于脑转移。结论　介入治疗对子宫内膜癌具有较好的疗效 ,可使部分患者达到HCR的效果。Objective To evaluate the therapeutic effects, pathological changes of interventional chemotherapy on endometrial carcinoma before operation.Methods Nine cases of endometrial carcinoma were performed interventional therapy before operation with carboplatin, epirubicin or ADM,and all the cases were performed the arterial chemoembolization with KMG or gel-foam particles mixed with 1/3 total drug dose after 2/3 total drug dose perfusion through the bilateral feeding arteries.Results 7 of 9 endometrial carcinoma cases were performed operations after 1～2 times of interventional therapy.In these cases,5 were found with mass necrosis and lymphocyte cells infiltration in the tumor tissue but with no carcinoma cells,which was noted as histological complete remission (HCR).One was observed few cancer cells and 1 with partial necrosis in the tumor tissue;1 in Ⅳ phase was unresectable after twice uterine arterial chemotherapy,1 of Ⅳ,46 days after the vaginal bleeding successfully coagulated,died of cerebral metastasis.Conclusion The ultraselective intrapelvic arterial chemotherapy is effective for endometrial carcinoma.Some patients can reach HCR.

关 键 词：子宫内膜癌 介入治疗 癌组织 病理学 

分 类 号：R737.33[医药卫生—肿瘤]