论文部分内容阅读
目的分析年轻子宫内膜癌患者临床病理特点,探讨其保留生育功能的风险及安全性评估。方法回顾某院2004年1月～2007年6月住院手术治疗且≤45岁的原发子宫内膜癌患者104例,总结其临床病理特点。结果 (1)≤45岁子宫内膜样腺癌与非子宫内膜样癌相比,两者在分化级别、肌层浸润、宫颈侵犯、脉管癌栓、卵巢转移、淋巴结转移等差异有统计学意义(P﹤0.05),且高分化患者均无宫颈侵犯及宫外转移。(2)术前诊刮为子宫内膜样腺癌者88例,96.6%患者与术后病理类型相符,30.4%的高分化患者被低估了分化级别。(3)临床I期87例年轻患者中,5.7%术后分期上升。高分化或者无肌层浸润患者均无宫颈侵犯、脉管癌栓、淋巴结及卵巢转移。结论≤45岁的高分化子宫内膜样腺癌患者临床病理上表现为低危性特征,这为保留生育功能创造了可行性。但术前诊刮低估了分化级别,临床分期存在误差,治疗存在较多风险。如何选择合适的病例及准确评估风险,是今后保留生育功能治疗研究的重点之一。
Objective To analyze the clinicopathological characteristics of young patients with endometrial carcinoma and to explore the risk and safety assessment of their reproductive function. Methods A retrospective review of 104 patients with primary endometrial cancer who underwent hospitalization for surgical treatment between January 2004 and June 2007 and ≤45 years old was reviewed. The clinical and pathological features were summarized. Results (1) The difference between endometrial adenocarcinoma ≤ 45 years old and non-endometrioid carcinoma was statistically significant (P <0.05), and there was no cervical invasion and extrauterine metastasis in well-differentiated patients. (2) 88 cases of endometrioid adenocarcinoma were treated by preoperative curettage, 96.6% were consistent with the postoperative pathological types, and 30.4% of well-differentiated patients were underestimated the level of differentiation. (3) Of 87 young patients in clinical stage I, 5.7% were postoperatively staged. Patients with well-differentiated or non-myometrial invasion had no cervical invasion, vascular thrombus, lymph node and ovarian metastasis. Conclusion Clinically and pathologically, patients with well-differentiated endometrioid adenocarcinoma of ≤45 years old have low-risk characteristics, which has made it feasible to retain fertility. Preoperative curettage underestimate the level of differentiation, there are errors in clinical staging, treatment there is more risk. How to select the appropriate cases and accurately assess the risk is one of the focuses of research on the maintenance of fertility in the future.