[1]戴晓怡,卢建军*,郭丽,等.特殊病理类型子宫内膜癌术前、术后相关因素 及预后的分析[J].中国计划生育和妇产科,2018,(12):82-85.
　DAI Xiao-yi,LU Jian-jun*,GUO Li,et al.Analysis of preoperative and postoperative factors and prognosis of endometrial carcinoma with special pathological type[J].Chinese Journal of Family Planning & Gynecotokology,2018,(12):82-85.
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特殊病理类型子宫内膜癌术前、术后相关因素 及预后的分析
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年12期
页码:
82-85
栏目:
论著与临床
出版日期:
2018-12-25

文章信息/Info

Title:
Analysis of preoperative and postoperative factors and prognosis of endometrial carcinoma with special pathological type
作者:
戴晓怡; 卢建军*; 郭丽; 刘亚萍
内蒙古医科大学附属医院妇产科
Author(s):
DAI Xiao-yi; LU Jian-jun*; GUO Li; LIU Ya-ping
Department of Gynecology and Obstetrics, The Affiliated Hospitol of Inner Mongolia Medical University, Huhhot Inner Mongolia 010050,P.R.China
关键词:
特殊病理类型子宫内膜癌; 子宫内膜样腺癌; 相关因素; 预后
Keywords:
specific pathologic type; uterine papillary serous carcinoma;  uterine clear cell carcinoma;  carcinosarcoma;  endometrioid adenocarcinoma
分类号:
R 73733
摘要:
目的对比特殊病理类型子宫内膜癌（endometrial carcinoma，EC）与子宫内膜样腺癌术前、术后相关因素的影响。方法收集2006年12 月至2011年12月内蒙古医科大学附属医院病理诊断为特殊病理类型（子宫乳头状浆液性腺癌、透明细胞癌、癌肉瘤）的EC患者，均行分期手术，术后病理证实仍为此类病理类型的患者57例,将其与同一时间段子宫内膜样腺癌患者538例作对比，进行EC预后的单因素及多因素分析。结果子宫内膜样腺癌患者就诊年龄、初潮年龄小于特殊病理类型EC患者，高血压、糖尿病、肥胖(体质量指数＞28 kg/m2)所占比例、术前血清糖类抗原（carbohydrate antigen,CA)125 阳性率、术前雌二醇(estradiol,E2)水平均高于特殊病理类型EC患者(P＜005)。两组原发不孕、继发不孕、绝经年龄、绝经后阴道出血、血清 CA 199 阳性率比较，差异无统计学意义（P＞005）。术后分期，特殊病理类型EC患者中Ⅱ期、Ⅲ期、Ⅳ期所占比例高于、Ⅰ期所占比例低于子宫内膜样腺癌患者 (P＜005)。术后特殊病理类型EC患者腹水细胞阳性率、p 53阳性率高于、雌激素受体阳性率低于子宫内膜样腺癌患者(P＜005)；两组孕激素受体阳性率比较差异无统计学意义(P＞005)。子宫内膜样腺癌术后生存率高于、复发率低于特殊病理类型EC患者（P＜005）。结论术前E2增高、CA 125增高，子宫内膜样腺癌可能性大。特殊病理类型EC患者发病时期别较晚，恶性程度高，危险因素多，易复发，5年生存率低，预后差。故早发现、早治疗，对提高患者预后有重要意义。
Abstract:
ObjectiveTo compare the effects of preoperative and postoperative factors on specific pathological types of endometrial cancer (EC) and endometrioid adenocarcinoma.MethodsPatients with EC pathology diagnosed as a special pathological type (uterine papillary serous adenocarcinoma, clear cell carcinoma, carcinosarcoma) from December 2006 to December 2011 at The Affiliated Hospital of Inner Mongolia Medical University all undwent staging operations. Postoperative pathology report confirmed still 57 cases of this pathological type of patients,they were compared with 538 cases of endometrioid adenocarcinoma in the same time period, and the univariate and multivariate analysis of EC prognosis was performed. ResultsPatients with endometrioid adenocarcinoma had a lower age of admission and menarche than those with specific pathological types of EC, hypertension, diabetes, and obesity (BMI>28 kg/m2), preoperative serum CA 125 positive rate, the level of preoperative estradiol (E2) was higher than that of patients with special pathological type EC (P<005). There was no significant difference between the two groups in the rates of primary infertility, secondary infertility, age of menopause, postmenopausal vaginal bleeding, and serum CA 199 positive rate(P>005).About postoperative staging, the proportion of stage II, III, and IV in patients with specific pathological types of EC was higher，and stage I was lower than that in patients with endometrioid adenocarcinoma (P<005).The positive rate of ascites cell and p53 were higher in patients with special pathological types of EC after surgery, and the positive rate of estrogen receptor was lower than that of endometrioid adenocarcinoma (P<005); the positive rate of progesterone receptors between the two groups had no significant difference(P>005). The survival rate of endometrioid adenocarcinoma was higher，and recurrence rate lower than that of patients with special pathological type EC (P<005). ConclusionWith preoperative estrogen E2 increases, CA 125 increases, endometrial adenocarcinoma is more likely. The pathological type of patients with special pathological type EC is later, the degree of malignancy is high, there are many risk factors, easy to relapse, the 5-year survival rate is low, and the prognosis is poor. Therefore, early detection and early treatment are important for improving the prognosis of patients.

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备注/Memo

备注/Memo:
内蒙古自治区自然科学基金 （项目编号: 2014 MS 0849)
更新日期/Last Update: 2018-12-25