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我科十年间手术治疗宫体癌病人138例,32例复发,复发率23.19％,其中I期～置期复发率为14.28％、41.66％和77.78％,内膜样腺癌复发率为20％,其中Ⅲ级为66.57％,桨液性腺癌为75％,透时细胞癌为66.67％,对肿瘤肌层浸润深度、大小、血管、宫颈、附件受侵及淋巴结转移情况进行分析显示复发率均发生依其程度加重而上升;术后补充放疗组与非放疗组盆腔复发率相近,术后两年内为复发高峰,五年后基本无复发;得出结论:宫体癌术后病人其临床期别、肿瘤大小及浸润深度与复发率成正比;有宫颈浸润、附件及淋巴结转移者,低分化腺癌、浆液性腺癌、透明细胞癌例呈高复发率,术后两年内为复发高峰。术前、术中、术后充分考虑,尽可能地明确前述因素而采取相对彻底的手术,术后即行积极有效的辅助治疗是当务之急。
In the past 10 years, 138 cases of uterine cancer were treated surgically in our department, of which 32 cases relapsed with a recurrence rate of 23.19%. The relapse rates of stage Ⅰ ~ stage were 14.28%, 41.66% and 77.78%, respectively. The recurrence rate of endometrial adenocarcinoma was 20% , Of which grade Ⅲ was 66.57%, parathyroid carcinoma was 75% and penetrating cell carcinoma was 66.67%. Analysis of invasion depth, size, invasion of blood vessels, cervix, accessory and lymph node metastasis showed that recurrence rate The occurrence of pelvic recurrence after radiotherapy group and non-radiotherapy group was similar, with peak recurrence within two years after operation, and no relapse after five years. The conclusion was that the clinical stage of patients with postoperative uterine cancer The tumor size and depth of invasion were directly proportional to the recurrence rate. Cervical infiltration, attachment and lymph node metastasis, poorly differentiated adenocarcinoma, serous adenocarcinoma and clear cell carcinoma showed high recurrence rate and peak recurrence within two years after operation. Preoperative, intraoperative and postoperative fully considered, as clear as possible the aforementioned factors to take relatively complete operation, postoperative positive and effective adjuvant treatment is a top priority.