论文部分内容阅读
目的:研究宫腔镜检查对Ⅱ型子宫内膜癌患者腹腔细胞学结果及预后的影响,探讨其用于Ⅱ型子宫内膜癌术前诊断的安全性。方法:回顾分析2001年6月至2010年6月在我院接受手术治疗且术后确诊为Ⅱ型子宫内膜癌的84例患者的临床病理资料。根据其术前诊断方式,分为宫腔镜检查组(32例)和传统诊刮组(52例)。比较两组患者的临床病理特点和腹腔细胞学检查阳性率,评价宫腔镜检查对Ⅱ型子宫内膜癌癌细胞腹腔播散的影响;分析术前不同诊断方式对Ⅱ型子宫内膜癌患者预后的影响。结果:两组患者的年龄、病理类型、临床分期、肌层浸润、累及附件及淋巴转移及治疗方式等比较,差异均无统计学意义(P>0.05)。宫腔镜诊刮组与传统诊刮组的腹水细胞学检查阳性率分别为37.5%(12/32)和17.3%(9/52),差异有统计学意义(χ~2=4.308,P=0.036)。宫腔镜检查组与传统诊刮组患者的5年总生存率(OS)分别为56.8%和69.2%,5年无进展生存率(PFS)分别为50.7%和67.9%;两组患者的总生存率曲线和无进展生存曲线分别比较,差异均无统计学意义(P=0.329;P=0.424)。结论:宫腔镜检查用于Ⅱ型子宫内膜癌的诊断,可增加癌细胞腹腔播散的风险,但对其长期生存可能无影响。
Objective: To study the effect of hysteroscopy on peritoneal cytology and prognosis of patients with type Ⅱ endometrial carcinoma and to explore its safety for the preoperative diagnosis of type Ⅱ endometrial carcinoma. Methods: The clinical and pathological data of 84 patients with type Ⅱ endometrial cancer who underwent surgical treatment in our hospital from June 2001 to June 2010 were retrospectively analyzed. According to its preoperative diagnosis, divided into hysteroscopy group (32 cases) and traditional curettage group (52 cases). The clinicopathological characteristics and the positive rate of peritoneal cytology in both groups were compared to evaluate the effect of hysteroscopy on the dissection of type Ⅱ endometrial cancer cells.All the patients with type Ⅱ endometrial carcinoma The impact of prognosis. Results: There was no significant difference in age, pathological type, clinical stage, myometrial invasion, appendages, lymph node metastasis and treatment between the two groups (P> 0.05). The positive rates of ascitic cytology in hysteroscopic curettage group and traditional curettage group were 37.5% (12/32) and 17.3% (9/52), respectively, with significant difference (χ ~ 2 = 4.308, P = 0.036). The 5-year overall survival (OS) of the hysteroscopy group and the traditional curettage group were 56.8% and 69.2%, respectively, and the 5-year progression-free survival rates were 50.7% and 67.9%, respectively. There was no significant difference between survival rate and progression free survival curve (P = 0.329; P = 0.424). Conclusions: Hysteroscopy is used to diagnose type II endometrial cancer, which increases the risk of peritoneal dissemination of cancer cells but may have no effect on its long-term survival.