单纯腹腔细胞学阳性子宫内膜癌Ⅲa期患者的预后

Different prognosis of patients with stage Ⅲa endometrial carcinoma

目的 研究不同子宫内膜癌Ⅲa期患者的预后 ,为临床治疗提供依据。方法 对 1988～ 2 0 0 1年在我院收治的子宫内膜癌Ⅰ期、Ⅲ期患者共 191例进行回顾性分析。患者共分为四组 :第一组为Ⅰ期患者 ,共134例 ;第二组为单纯腹腔细胞学阳性的子宫内膜癌Ⅲa期患者 ,共 2 3例 ;第三组为伴有浆膜浸润或附件转移的子宫内膜癌Ⅲa期患者 ,共 16例 ;第四组为子宫内膜癌Ⅲb期 +Ⅲc期患者 ,共 18例。采用Kaplan -Meier法对四组的平均生存时间进行计算 ,并进行比较。结果 ①第一组与第二组的平均生存时间差异无显著性 ,P >0 0 5 ;②第二组与第三组的平均生存时间差异有明显统计学意义 ,P <0 0 1;③第三组与第四组的平均生存时间差异无显著性 ,P >0 0 5。结论 尽管腹腔细胞学阳性、浆膜浸润及附件转移均被定为子宫内膜癌Ⅲa期 ,但单纯腹腔细胞学阳性的患者其预后明显好于伴有浆膜层浸润或附件转移者。

Objective To investigate the different prognosis of patients with different stage Ⅲa endometrial carcinoma,i e positive peritoneal cytology, or(with)invasion of uterine serosa and adnexa metastasis Methods The clinicopathological data of the patients with stage Ⅰ and stage Ⅲ endometrial carcinoma treated in our hospital from 1988 to 2001 were analyzed retrospectively One hundred and ninety-one patients were divided into four groups,group 1(n=134) stage Ⅰ patients,group 2 (n=23) Ⅲa with positive peritoneal cytology alone,group 3 (n=16) Ⅲa with invasion of uterine serosa or adnexa metastasis,group 4 (n=18)Ⅲb and Ⅲc The mean survival time of the four groups was calculated with Kaplan-Meier method and COX regression was used to study the relative risk factors Results There was no difference of the mean survival time between group 1 and 2,neither does that between group 3 and 4,while there was statistical difference between group 2 and 3( P <0 01) Conclusions The prognosis of the stage Ⅲa patients with only positive peritoneal cytology is much better than other Ⅲa patients They should be treated differently