摘要
目的 探讨晚期子宫内膜癌复发特征及其相关因素。方法 回顾性分析 1989年 8月至 2 0 0 1年 5月间收治的 2 0例晚期子宫内膜癌复发患者临床病理资料 ,并与同期未复发患者进行比较。结果 ① 6 0例晚期子宫内膜癌患者 ,随访 1～ 7年 ,发现复发转移 2 0例 ,复发率 33 3% ,其中Ⅲ期 13例 ,Ⅳ期 7例 ;②复发转移首发部位 :盆腹腔 9例 ,肺转移 8例 ,其他部位 3例 ;③临床特征 :Ⅲc和Ⅳ期复发率分别为 4 0 9%和 6 3 6 % ,显著高于Ⅲa(12 5 % ) (P <0 0 5 ) ;术后有残存病灶者复发率为 72 7% ,无残存者仅为 2 4 5 % ,差异有显著性意义 (P <0 0 5 )。④病理特征 :复发率在侵肌≥ 1/ 2者为 5 0 0 % ,侵肌 <1/ 2者为 18 7% ,有宫旁受侵者为 5 8 3% ,而未受侵害者为2 7 1% ,差异均有统计学意义 (P <0 0 5 ) ;低分化癌的复发率 (5 5 0 % )显著高于中分化癌 (2 5 0 % )和高分化癌(2 0 0 % ) (P <0 0 5 ) ;而淋巴结有癌转移的复发率 (46 2 % )和无癌转移者 (2 3 5 % )差异无显著性意义 (P >0 0 5 ) ;⑤复发与治疗方式 :术后辅助化疗和放疗的复发率最低 (13 3% ) ,其次为术后辅助化疗 (31 8% )。结论 晚期子宫内膜癌复发率高 ,最常见的复发转移部位为盆腹腔和肺 ,多数在 2年内复发 。
Objective To study the characteristics and related factors of recurrence and metastasis in advanced endometrial carcinoma.Methods The clinic-pathological features of 60 patients with advanced endometrial carcinoma,admitted during August 1989 to May 2001,were analyzed retrospectively.Among them,20 cases with recurrence and metatasis were compared with those without recurrence and metastasis. Results ①A follow-up of 1～7 years found 20 cases with recurrence and metastasis,the recurrence rate being 33 3%,of which,stage Ⅲ was in 13 cases,stage Ⅳ 7 cases.②There were 9 cases of metastasis presented first in pelvic and peritoneal cavity,8 cases in lungs and 3 in other sites.③The recurrence rate was 12 5% in stage Ⅲa,which was significantly lower than that of 40 9% in stage Ⅲc and 63 6% in stage Ⅳ,respectively (P<0 05).In cases of residual lesion,the recurrence rate was 72 7%,which was significantly higher than those without residual lesion (24 5%)(P<0 05).④The relapse rate was higher in the following status:deep myometrial invasion (≥1/2)(50 0%),myometrial invasion<1/2 (18 7%)(P<0 05);para-uterine tissues invasion (58 3%),without para-uterine tissue invasion (27 1%)(P<0 05);the recurence rate of low-differentiated cases (55 0%) was significanly higher than that of moderate (25 0%) and high-differentiated cases (20 0%)(P<0 05);there was no significant difference in the recurrence rate between cases with lymph node involvement (46 2%) and cases without (23 5%).⑤The rate of relapse was the lowest in patients treated with surgery and adjuvant chemotherapy and radiotherapy (13 3%),the next was surgery and adjuvant chemotherapy (31 8%).Conclusion The rate of recurrence and metastasis is higher in advanced endometrial carcinoma.The most common sites of recurrence and metastasis are pelvic and peritoneal cavity and lung.The average time of recurrence and metastasis is usually less than 2 years.The high risk factors of recurrence and metastasis include stage,myometrial invasion,differentiation,para-uterine tissues invasion,and residual lesion.The optimal treatment strategy might be surgery with adjuvant chemotherapy and radiotherapy.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2003年第9期537-540,共4页
Chinese Journal of Practical Gynecology and Obstetrics
