摘要
目的：探讨低分化子宫内膜样腺癌分型归属问题。方法：收集2000年1月1日—2010年12月31日广东省妇幼安康工程子宫内膜癌防治项目医院高分化和中分化子宫内膜样腺癌（grade 1 and grade 2 endometrioid endometrial carcinoma,G1EEC/G2EEC）4 026例,低分化子宫内膜样腺癌（grade 3 endometrioid endometrial carcinoma,G3EEC）619例,子宫浆液性腺癌（uterine serous carcinoma,USC）和透明细胞癌（clear cell carcinoma,CCC）166例,进行回顾性分析,比较3组患者的临床病理特征和预后,探讨G3EEC分型归属问题。结果：1G3EEC组与USC＋CCC组的超重/肥胖（40.6%vs.37.7%,P=0.625）以及未产的比例（4.2%vs.2.5%,P=0.323）相比较差异无统计学意义,且低于G1EEC/G2EEC组;G3EEC组与USC＋CCC组的绝经患者（64.1%vs.70.5%,P=0.127）、首发症状为腹痛和腹胀（4.7%vs.6.0%,P=0.481）以及手术病理分期为晚期患者的比例（32.8%vs.31.3%,P=0.720）相比较差异均无统计学意义,且高于G1EEC/G2EEC组。2G3EEC组与USC＋CCC组肿瘤局限于宫腔下部（14.1%vs.18.1%,P=0.279）、深肌层浸润（43.6%vs.39.8%,P=0.372）、淋巴血管间隙受累（9.4%vs.11.4%,P=0.425）、宫颈间质侵犯的比例（23.6%vs.21.7%,P=0.607）以及盆腔淋巴结转移率（24.7%vs.24.3%,P=0.927）相比较差异无统计学意义,且高于G1EEC/G2EEC组。3G3EEC组与USC＋CCC组的生存时间和无进展生存时间比较差异无统计学意义（P分别为0.544和0.939）。Cox回归分析显示,G3EEC组的生存时间（HR=4.147,95%CI：2.573~6.683,P〈0.001）和无进展生存时间（HR=3.365,95%CI：2.300~4.923,P〈0.001）低于G1EEC/G2EEC组。结论：G3EEC与USC及CCC有相似的临床病理特征及预后,而不同于G1EEC/G2EEC,低分化子宫内膜样腺癌归为Ⅱ型子宫内膜癌更为合理。
ObjectiveTo determine whether grade 3 endometrioid endometrial carcinoma （G3EEC） could be more akin totype I or II cancer. Methods： Between January 2000 and December 2010,4 811 patients were extracted from the collaborationhospitals in the center for endometrial cancer control and presentation in Guangdong, China. We performed a retrospective studyof clinicopathological parameters and survival data in three different populations including grade 1 and grade 2 endometrioidendometrial carcinoma （G1EEC/G2EEC, n=4 026）, G3EEC （n=619）, uterine serous carcinoma and clear cell carcinoma（USC/CC,n=166）. Results： In G3EEC group and USC＋CCC group, propotion of obese and fatty women （40.6% vs. 37.7%, P=0.625）,propotion of nulparity （4.2% vs. 2.5%, P=0.323）, percentage of menopause （64.1% vs. 70.5% ,P =0.127）, percentage ofabodominal symptoms （4.7% vs. 6.0%, P=0.481）, percentage of advanced surgical stage （32.8% vs. 31.3%, P=0.72） wereassembled,and there was a significant difference while compared to G1EEC/G2EEC. G3EECs shared similar pathologicalfeatures including percentage of lower uterine segment involvement （14.1% vs. 18.1% ,P=0.279）, deep myometrial invasion（43.6% vs. 39.8%,P=0.372）, invasion of lymph-vascular spaces （9.4% vs. 11.4%,P=0.425）, incidence rates of cervical stromalinvasion （23.6% vs. 21.7% ,P=0.607） and lymph node metastasis incidence （24.7% vs. 24.3% ,P=0.927）, higher than G1EEC/G2EECs . There was no significant difference in overall survival（P=0.544） and progress free survival（P=0.939） for G3EECs andUSCs/CCCs. Using a Cox regression analysis, G3EECs had a significantly decreased overall survival and progress free survivalcompared to GlEEC/G2EECs [HR = 4.141,95% Cl （2.573-6.683） ,P 〈 0 .001 ; =3.365,95%C/ （2.300-4.923）,P 〈0.001]. Conclusions ： According to clinicopathologic features and outcome, G3EEC may be better characterized as type IIendometrial cancer.[
出处
《国际妇产科学杂志》
CAS
2016年第4期442-445,共4页
Journal of International Obstetrics and Gynecology
基金
国家自然科学基金(30772332)
广东省自然科学基金面上项目(S2012010008640)
关键词
子宫内膜肿瘤
癌
组织学
临床病理学
预后
回顾性研究
Endometrial neoplasms
Carcinoma
Histology
Pathology, clinical
Prognosis
Retrospective studies
