中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
23期
1612-1614
,共3页
子宫内膜肿瘤%肿瘤分期
子宮內膜腫瘤%腫瘤分期
자궁내막종류%종류분기
Endometrial neoplasms%Neoplasms staging
目的 探讨子宫内膜癌新旧手术病理分期治疗合理性及临床意义.方法 对浙江萧山医院2005年6月至2011年6月收治的92例子宫内膜癌患者(年龄35 ～ 78岁)临床与预后随访资料进行回顾分析,并重新进行新旧手术病理分期,观察其分期合理性及治疗预后.结果 92例术后旧分期为:Ⅰ期67例(72.8％),Ⅱ期7例(7.6％),Ⅲ期18例(19.6％).新分期Ⅰ期79例(85.9％),Ⅱ期3例(3.3％),Ⅲ期10例(10.9％).术中腹腔液常规细胞学阳性检出率为8.7％ (8/92),盆腔淋巴结阳性率12.9％ (11/85).术后3及5年ⅠA、ⅠB、ⅡA期生存率比较差异无统计学意义,P＞0.05；而ⅠB期与ⅠC期比较差异有统计学意义,P＜0.05,深肌层浸润生存率显著短于浅肌层.腹主动脉淋巴结阳性率3.8％ (1/26),6例淋巴结阳性者分别于术后4～28个月内死于癌症.结论 子宫内膜癌新分期较1988年的旧分期更加客观、实用,也更简便.子宫内膜癌深肌层及淋巴阳性是影响预后的重要因素.早期低危子宫内膜癌淋巴结阳性率低,常规淋巴结切除意义不大.
目的 探討子宮內膜癌新舊手術病理分期治療閤理性及臨床意義.方法 對浙江蕭山醫院2005年6月至2011年6月收治的92例子宮內膜癌患者(年齡35 ～ 78歲)臨床與預後隨訪資料進行迴顧分析,併重新進行新舊手術病理分期,觀察其分期閤理性及治療預後.結果 92例術後舊分期為:Ⅰ期67例(72.8％),Ⅱ期7例(7.6％),Ⅲ期18例(19.6％).新分期Ⅰ期79例(85.9％),Ⅱ期3例(3.3％),Ⅲ期10例(10.9％).術中腹腔液常規細胞學暘性檢齣率為8.7％ (8/92),盆腔淋巴結暘性率12.9％ (11/85).術後3及5年ⅠA、ⅠB、ⅡA期生存率比較差異無統計學意義,P＞0.05；而ⅠB期與ⅠC期比較差異有統計學意義,P＜0.05,深肌層浸潤生存率顯著短于淺肌層.腹主動脈淋巴結暘性率3.8％ (1/26),6例淋巴結暘性者分彆于術後4～28箇月內死于癌癥.結論 子宮內膜癌新分期較1988年的舊分期更加客觀、實用,也更簡便.子宮內膜癌深肌層及淋巴暘性是影響預後的重要因素.早期低危子宮內膜癌淋巴結暘性率低,常規淋巴結切除意義不大.
목적 탐토자궁내막암신구수술병리분기치료합이성급림상의의.방법 대절강소산의원2005년6월지2011년6월수치적92례자궁내막암환자(년령35 ～ 78세)림상여예후수방자료진행회고분석,병중신진행신구수술병리분기,관찰기분기합이성급치료예후.결과 92례술후구분기위:Ⅰ기67례(72.8％),Ⅱ기7례(7.6％),Ⅲ기18례(19.6％).신분기Ⅰ기79례(85.9％),Ⅱ기3례(3.3％),Ⅲ기10례(10.9％).술중복강액상규세포학양성검출솔위8.7％ (8/92),분강림파결양성솔12.9％ (11/85).술후3급5년ⅠA、ⅠB、ⅡA기생존솔비교차이무통계학의의,P＞0.05；이ⅠB기여ⅠC기비교차이유통계학의의,P＜0.05,심기층침윤생존솔현저단우천기층.복주동맥림파결양성솔3.8％ (1/26),6례림파결양성자분별우술후4～28개월내사우암증.결론 자궁내막암신분기교1988년적구분기경가객관、실용,야경간편.자궁내막암심기층급림파양성시영향예후적중요인소.조기저위자궁내막암림파결양성솔저,상규림파결절제의의불대.
Objective To explore the rationality and clinical significance for the old and new surgical-pathological staging in endometrial carcinoma.Methods The clinical profiles and prognostic particulars were analyzed retrospectively in 92 cases of endometrial carcinoma from June 2005 to June 2011 at Xiaoshan Hospital.And the old and new surgical-pathological staging methods were applied to observe their rationality and treatment prognosis.Results There was 72.8％ (67/92) for clinical stage Ⅰ in the old surgical-pathological staging while 7.6％ (7/92) for clinical stage Ⅱ and 19.7％ (18/92) for clinical stage Ⅲ.There was 85.9％ (79/92) for clinical stage Ⅰ in the new surgical-pathological staging,3.3％ (3/92)for clinical stage Ⅱ and 10.7％ (10/92) for clinical stage Ⅲ.The detection rate of cancer cell was 8.7％( 8/92 ) in peritoneal fluid.The positive rate of pelvic lymph node was 12.9％ ( 11/85 ).A period of survival rates were compared among P ＞ 0.05 after 3 years and 5 years of Ⅰ A, Ⅰ B and Ⅱ A.There was no statistical significance; there were statistical significance between Ⅰ B and Ⅰ C periods ( P ＜ 0.05 ).The survival of deep myometrial invasion was significantly shorter than that of superficial muscle layer.The positive rate of abdominal aortic lymph node was 3.8％ (1/26).Six patients with positive lymph nodes died postoperatively of cancer within 4 to 28 months.Conclusion The new surgical-pathological staging is more objective,practical,simple and convenient than its old counterpart.Deep myometrial infiltration and positive lymph node are important prognostic factors of endometrial carcinoma.The positive rate of lymph node remains low in early low-risk endometrial carcinoma and routine excision of lymph node is of little significance.
