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目的探讨子宫内膜癌病理学特征的多样性及其临床意义。方法收集子宫内膜癌82例,分析发病年龄、症状、病理学特点、浸润转移情况等。结果患者中位数年龄51岁,低于以往资料57岁。大多因阴道异常出血而就诊,但少数患者例外。病理类型有腺鳞癌、癌肉瘤、透明细胞癌、黏液癌、内膜样腺癌、不典型增生过长癌变。前三者子宫旁浸润、淋巴结转移率明显高于内膜样腺癌。低分化(G3)的深肌层浸润率和淋巴结转移率明显高于高分化(G1)和中分化(G2)。结论子宫内膜癌患者有年轻化趋势。病理类型在群体水平呈现多样性。癌细胞分化越低,浸润及转移危险越大。癌肉瘤和透明细胞癌生物学行为多恶劣,内膜样腺癌G3浸润转移能力也较强,提示应给予盆腔淋巴结清扫等综合治疗。
Objective To explore the diversity of pathological features of endometrial carcinoma and its clinical significance. Methods 82 cases of endometrial cancer were collected, and their age, symptoms, pathological features, infiltration and metastasis were analyzed. Results The median age of patients was 51 years old, 57 years lower than the previous data. Mostly due to abnormal vaginal bleeding and treatment, but a few exceptions. Pathological types of adenosquamous carcinoma, carcinosarcoma, clear cell carcinoma, mucinous carcinoma, endometrial adenocarcinoma, atypical hyperplasia of cancer. The first three para-uterine infiltration, lymph node metastasis was significantly higher than endometrial adenocarcinoma. Poorly differentiated (G3) deep myometrial invasion rate and lymph node metastasis rate was significantly higher than the well-differentiated (G1) and moderately differentiated (G2). Conclusion The trend of younger patients with endometrial cancer. Pathological types show diversity at the population level. The lower the differentiation of cancer cells, the greater the risk of invasion and metastasis. Carcinosarcoma and clear cell carcinoma of the biological behavior of more harsh, endometrial adenocarcinoma G3 invasion and metastasis is also strong, suggesting that pelvic lymph node dissection should be given such as comprehensive treatment.