子宫内膜透明细胞癌的诊治进展

发布时间：2018-03-31 15:27

本文选题：子宫内膜癌　切入点：透明细胞癌　出处：《蚌埠医学院》2014年硕士论文

【摘要】：子宫内膜透明细胞癌（ECCC）是子宫内膜癌的特殊病理类型，其发病率约占子宫内膜恶性肿瘤的2%～4%[3]，五年生存率仅有52%[4]。而且近年来其发病有增高趋势[1]。又因ECCC恶性程度高，早期容易发生远处脏器及淋巴结转移，浸润转移率明显高于子宫内膜样腺癌，宫腔内病灶的大小不能预测肌层浸润深度及有无宫外转移[5]。同时ECCC缺乏有效的诊断治疗方法，因此通过阅读分析文献资料，，对国内外近年有关子宫内膜透明细胞癌的诊断及治疗方面的新理念、新方法进行综述，以促使临床医生加深对ECCC的认识，为临床医生提供诊治的新思路、更新治疗方法。ECCC为苗勒管起源，单纯的透明细胞癌比较少见，常常与其他病理类型混合存在，预后较差。其病因不明，但与P53突变关系密切。ECCC临床诊断方面，目前宫腔镜下取子宫内膜病理检查被认为是诊断金标准。影像学检查仍依据多普勒超声、CT及MRI检查。分子生物学研究表明HNF1β、HE4、CDC25、LICAM、ck7及cyclingE在ECCC中均较高表达，有望成为ECCC早期诊断的肿瘤标志物，但需要更多病例进一步证实。手术治疗是ECCC患者的首选治疗。早期患者实行全面手术分期是必要的。晚期患者行肿瘤细胞减灭术，对期别较晚的ECCC患者介入治疗后再手术可以改善患者预后。术后辅助化疗和放疗能改善预后。分子靶向药物对ECCC有一定疗效，但尚未广泛应用于临床，有待进一步实验研究来证实其安全性及有效性。
[Abstract]:Endometrial clear cell carcinoma (Ecc) is a special pathological type of endometrial carcinoma. Its incidence is about 2% [3] of endometrial malignant tumors, and the 5-year survival rate is only 52% [4]. Distant organ and lymph node metastasis are easy to occur in early stage, and the rate of invasion and metastasis is obviously higher than that of endometrioid adenocarcinoma. The size of intrauterine lesions can not predict the depth of myometrial invasion and extrauterine metastasis [5]. At the same time, ECCC is lack of effective diagnostic and therapeutic methods. Therefore, through reading and analyzing the literature, this paper summarizes the new ideas and methods of diagnosis and treatment of endometrial clear cell carcinoma at home and abroad in recent years, in order to promote the clinicians to deepen their understanding of ECCC. To provide clinicians with a new way of diagnosis and treatment. ECCC is the origin of Mullerian tube, simple clear cell carcinoma is rare, often mixed with other pathological types, the prognosis is poor, its etiology is unknown. But it is closely related to p53 mutation. ECCC clinical diagnosis, At present, the pathological examination of endometrium under hysteroscopy is considered as the diagnostic gold standard. The imaging examination is still based on Doppler ultrasound CT and MRI. Molecular biology studies show that HNF1 尾 -HE4, CDC25, LICAMAMK7 and cyclingE are both highly expressed in ECCC. It is expected to be a tumor marker for early diagnosis of ECCC, but more cases need to be confirmed. Surgical treatment is the first choice for patients with ECCC. Postoperative adjuvant chemotherapy and radiotherapy can improve the prognosis of patients with ECCC after interventional therapy. Molecular targeting drugs have certain curative effect on ECCC, but they have not been widely used in clinical practice. Further experimental research is needed to prove its safety and effectiveness.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

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