影响子宫内膜癌疗效因素的探讨

EVALUATION OF THERAPEUTIC FACTORS OF ENDOMETRIAL CARCINOMA

１９８３年～１９９３年收治子宫内膜癌６０例中Ⅰ＿ａ期６例（１０％），Ⅰ＿ｂ期２５例（４１．７％），Ⅰ＿ｃ期１７例（２８．３％），Ⅱ期２例（３．３％），Ⅲ期８例（１３．３％），Ⅳ期２例（３．３％）。以腺癌和乳头状腺癌为主，占８５％。高度分化４４％，中度分化４９％，低度分化７％。年龄≤４５岁１２例，占２０％。癌组织雌激素受体（ＥＲ）阳性占９３％，孕激素受体（ＰＲ）阳性占９０．７％，二者均阴性占２．３％。６０例均行手术，术后辅以放疗１０例，激素治疗４７例，化疗１３例。随访５８例中死亡１３例。用寿命表法计算Ⅰ期４８例的二年、五年、十年生存率分别为９２％，８７％及８１％。本研究结果提示影响子宫内膜癌疗效的因素主要有年龄、临床病理分期、病理类型、组织学分级、肌层浸润深度、激素受体状态、综合治疗方法等。

ixty patients of endometrial carcinoma were admitted during 1983～1993. Amongthem,6 cases(10%)belonged to stage Ⅰ_a ,25(41.7%)to Ⅰ_b, 17(28.3%)to Ⅰ_c,and 2(3.3%)toⅡ,8(13.3%)toⅢ,2(3.3%)to Ⅳ. The pathological categories were main-ly adenocarcinoma and papillary adernocarcinoma,amounting to 85%. According to his-tological grading: grade Ⅰ was 44%, gradeⅡ49%. gradeⅢ7%.There were 12 cases(20%)below the age of 45 years. Estrogen receptor (ER)was positive in 93%of casesand progesterone receptor(PP.)was positive in 90.7%,both being negative in 2.3%.All cases were treated surgically. After operation 10 cases received radiotherapy,47 caseswere medicated with progestin and/or tomoxifen, while 13 cases accepted adjunctive che-motherapy. A follow-up survey of 58 cases revealed 13 postoperative deaths.The lifetable survival rates of Stage Ⅰ(48 cases) were 92%,87%and 81%for 2,5 and 10years respectively. The result of this study suggests age,clinical stage,pathologicalcategory,histological grading,myometrial infiltration,hormonal receptor status andComprehensive treatment modality are the chief therapeutic factors of endometrial carcinoma.