22例子宫内膜癌复发病例的临床特点分析

发布时间：2018-03-06 20:24

  本文选题：子宫内膜癌　切入点：复发　出处：《中国微创外科杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的总结子宫内膜癌复发的临床特点。方法 2006年1月~2015年12月,我院首次确诊为子宫内膜癌,临床资料完整,经病理学诊断确诊为子宫内膜癌,前次手术为标准的系统分期手术,接受再次手术或穿刺病理证实为子宫内膜癌复发,并进行随访的患者共22例,对临床资料进行回顾性分析。结果 22例首次确诊内膜癌的中位年龄为52岁(44~63岁),绝经后阴道出血为子宫内膜癌最常见的临床症状(54.5%,12/22)。子宫内膜样腺癌18例(81.8%),浆液性腺癌3例(13.6%),透明细胞癌1例(4.5%)。子宫肌层受累情况:局限于黏膜内0例,肌层浸润1/2 14例(63.6%),肌层浸润1/2 7例(31.8%),肌层浸润达浆膜层1例(4.5%),穿透浆膜层0例;淋巴结阳性4例(18.2%),均为盆腔淋巴结,腹主动脉旁淋巴结均阴性。术后病理分期FIGOⅠA期12例(54.5%),ⅠB期5例(22.7%),Ⅱ期1例(4.5%),ⅢC_1期4例(18.2%)。中位肿瘤复发时间4年(1.5~7年),均无明显自觉症状,血清CA125升高12例(54.5%),超声或CT发现局部肿块9例(40.9%),体检胸部X线片发现肺占位1例(4.5%)。盆腔内复发14例(63.6%),腹膜后髂血管周围淋巴结复发6例(27.3%),前腹壁腹膜外转移合并肺转移复发1例(4.5%),肺转移复发1例(4.5%)。3例接受Lynch综合征筛查,其中2例阳性。结论子宫内膜癌复发病例中,肿瘤肌层浸润较常见,复发患者临床症状不明显,盆腔内复发为最常见的复发部位。
[Abstract]:Objective to summarize the clinical features of recurrence of endometrial carcinoma. Methods from January 2006 to December 2015, our hospital first diagnosed endometrial carcinoma with complete clinical data, and was diagnosed as endometrial carcinoma by pathology. The previous operation was a standard systematic staging operation, and 22 patients were followed up with recurrent endometrial carcinoma confirmed by re-operation or puncture pathology. Results the median age of 22 cases of first diagnosed endometrial carcinoma was 52 years old and 44 / 63 years old. Postmenopausal vaginal hemorrhage was the most common clinical symptom of endometrial carcinoma. There were 3 cases of gonadal carcinoma and 1 case of clear cell carcinoma. The involvement of myometrium was limited to the mucous membrane in 0 cases. There were 1/2 cases of myometrial infiltration in 1/2 cases, 1/2 cases of myometrium infiltration in 1/2 cases, 1 case of myometrium infiltration reaching serous layer in 1 case, and 1 case of penetrating serous layer in 0 cases, and 4 cases of lymph node positive in 4 cases, all of them were pelvic lymph nodes. FIGO stage 鈪，

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