目的:探讨子宫内膜浆液性癌（USC）的诊断、治疗及预后，并分析预后影响因素。方法:收集2004年1月1日至2014年12月31日在中国医学科学院北京协和医学院肿瘤医院接受手术治疗且随访资料完整的71例USC患者的临床病理资料，回顾性分析USC的诊断、治疗及预后，并分别采用Kaplan-Meier法及Cox回归分析进行单因素和多因素生存分析。结果:（1）诊断和治疗：71例患者中，32例（45%，32/71）患者术前诊断为USC，其中25例（35%，25/71）按照USC的手术范围接受了全面分期手术；25例全面分期手术患者中，10例（40%，10/25）患者术后手术病理分期较术前影像学检查提示的期别升高。（2）预后：71例USC患者中，随访期内18例复发，复发率为25%（18/71）；12例患者死亡，患者的5年无病生存（DFS）率和5年总生存（OS）率分别为76.5%和80.6%。（3）预后影响因素分析结果：单因素分析显示，年龄、淋巴结切除范围、术中腹腔冲洗液细胞学检查、肌层浸润深度、附件和（或）子宫浆膜受累、大网膜转移显著影响USC患者的5年DFS率（n P<0.05）；淋巴结切除范围、分期手术范围、术中腹腔冲洗液细胞学检查、附件和（或）子宫浆膜受累、术后辅助治疗方式显著影响USC患者的5年OS率（n P<0.05）。多因素分析显示，分期手术范围（n HR=5.18，95%n CI为1.04~25.70，n P=0.044）、附件和（或）子宫浆膜受累（n HR=8.41，95%n CI为2.28~31.05，n P=0.001）为影响USC患者5年DFS率的独立危险因素；淋巴结切除范围（淋巴结未切除与盆腔+腹主动脉旁淋巴结切除比较，n HR=27.76，95%n CI为1.76~437.78，n P=0.018；盆腔淋巴结切除与盆腔+腹主动脉旁淋巴结切除比较，n HR=5.98，95%n CI为1.11~32.27，n P=0.038）、术中腹腔冲洗液细胞学检查（n HR=5.47，95%n CI为1.18~25.39，n P=0.030）为影响USC患者5年OS率的独立危险因素。n 结论:USC的术前诊断困难，会导致分期手术不全面，影响患者的准确分期。分期手术范围、附件和（或）子宫浆膜受累、淋巴结切除范围、术中腹腔冲洗液细胞学检查为独立的预后影响因素，临床应给予充分重视。“,”Objective:To investigate the diagnosis, treatment and prognosis of uterine serous carcinoma (USC), and further analyze the prognostic factors.Methods:USC patients who underwent surgery with complete follow-up at Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences between January 1, 2004 and December 31, 2014 were retrospectively reviewed. The Kaplan-Meier method and Cox regression analysis were used for survival analysis.Results:(1) Diagnosis and treatment: the study included 71 USC patients. Only 32 patients (45%, 32/71) were diagnosed preoperatively with USC, and 25 cases of them (35%, 25/71) underwent USC standard comprehensive staging surgery. Of the 25 patients, 10 cases (40%, 10/25) had up-staged after operation. (2) Prognosis: the 5-year disease free survival (DFS) rate and overall survival (OS) rate for all patients were 76.5% and 80.6%, respectively. (3) The results of prognostic factors analysis: univariate analysis on age, range of lymphadenectomy, peritoneal cytology, the depth of myometrial invasion, adnexal and (or) serosa involvement and omentum metastasis were significantly associated with 5-year DFS rate (all n P<0.05); range of lymphadenectomy, range of surgical staging, peritoneal cytology, adnexal and (or) serosa involvement and postoperative adjuvant treatment were significantly associated with 5-year OS rate (alln P<0.05). Multivariate analysis on range of surgical staging (n HR=5.18, 95%n CI: 1.04-25.70, n P=0.044) and adnexal and (or) serosa involvement (n HR=8.41, 95%n CI: 2.28-31.05, n P=0.001) were independent prognostic factors for 5-year DFS rate; range of lymphadenectomy [no lymphadenectomy vs pelvic lymphadenectomy (PLN)+para-aortic lymphadenectomy (PALN), n HR=27.76, 95%n CI: 1.76-437.78, n P=0.018;PLN vs PLN+PALN, n HR=5.98, 95%n CI: 1.11-32.27, n P=0.038] and peritoneal cytology (n HR=5.47, 95%n CI: 1.18-25.39, n P=0.030) were independent prognostic factors for 5-year OS rate.n Conclusions:The preoperative pathological diagnosis of USC is difficult, resulting in incomplete surgical staging and inaccurate staging. Range of surgical staging, adnexal and (or) serosa involvement, peritoneal cytology and range of lymphadenectomy are independent prognostic factors, which deserve much attention in clinical practice.