子宫浆液性癌101例临床分析

发布时间：2018-03-08 12:47

本文选题：子宫内膜癌　切入点：浆液性癌　出处：《中国妇产科临床杂志》2015年01期 　论文类型：期刊论文

【摘要】：目的探讨子宫浆液性癌的临床病理特征和预后影响因素。方法回顾性分析2000年1月至2010年12月广东省子宫内膜癌防治项目101例子宫浆液性癌的临床病理特征及预后。结果子宫浆液性癌占同期子宫内膜癌的1.7%,患者的发病平均年龄(56.2±10.3)岁,多发于绝经后妇女(67.3%)。子宫浆液性癌术前的误诊率较高(74.7%),容易与低分化子宫内膜样腺癌混淆。术前CA125升高的患者多数为晚期(72.4%)。临床Ⅰ期患者术后分期升级占38.1%。无肌层浸润的患者中发生子宫外转移占38.5%。深肌层浸润占35.6%;淋巴血管间隙受累占16.8%;淋巴结转移占29.7%,其中无/浅肌层浸润占47.4%。86.2%的患者p53呈阳性。术后复发以远处转移为主,占77.3%(17/22)。子宫浆液性癌的5年总体生存率和5年无进展生存率分别为74.9%和67.9%;多因素分析显示,淋巴结转移是影响子宫浆液性癌总体生存率和无进展生存率的独立因素(P=0.015,P=0.001)。结论子宫浆液性癌发病年龄较大,多见于绝经后女性,术前病理误诊率高,易于发生子宫外转移,术前CA125升高对预测子宫外转移有一定意义。p53阳性是其重要的分子生物学特征。复发以远处转移为主,淋巴结转移是预后的重要影响因素。
[Abstract]:Objective to investigate the clinicopathological features and prognostic factors of uterine serous carcinoma. Methods the clinicopathological features and preconditioning of 101 cases of uterine serous carcinoma from January 2000 to December 2010 in Guangdong Province were analyzed retrospectively. Results serous carcinoma accounted for 1.7% of endometrial carcinoma in the same period. The average age of the patients was 56.2 卤10.3 years old. The misdiagnosis rate of serous carcinoma before operation is higher than 74.7%, which is easy to be confused with poorly differentiated endometrial adenocarcinoma. The majority of patients with elevated CA125 before operation are advanced stage 72.4%. Clinical stage I patients have postoperative stage and upgrade rate of 38.1%. Extrauterine metastasis was found in 38.5% of the patients, deep muscle invasion was 35.6%, lymphatic space involvement was 16.8%, lymph node metastasis was 29.7%, and no / superficial muscle invasion accounted for 47.4.86.2% of the patients were p53 positive. Postoperative recurrence was mainly distant metastasis. The 5-year overall survival rate and the 5-year progression-free survival rate of uterine serous carcinoma were 74.9% and 67.9, respectively. Lymph node metastasis is an independent factor that affects the overall survival rate and progressive survival rate of uterine serous carcinoma. Conclusion uterine serous carcinoma is more common in postmenopausal women and has a high rate of misdiagnosis before operation and is prone to extrauterine metastasis. Preoperative elevation of CA125 has a certain significance in predicting extrauterine metastasis. P53 positive is an important molecular biological feature. Distant metastasis is the main recurrence and lymph node metastasis is an important prognostic factor.
【作者单位】：中山大学附属第三医院妇产科;深圳市人民医院;中山大学附属肿瘤医院;中山大学附属第二医院;
【基金】：国家自然科学基金(30772332) 广东省自然科学基金(S2012010008640) 广东省科技计划项目(20100309) 广东省妇幼安康工程——子宫内膜癌防治项目(2010)
【分类号】：R737.33

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