子宫内膜癌的特殊类型——子宫乳头状浆液性癌

UterinePapilarySerousCarcinoma OneKindofSpecialTypeofUterineEndometrialCarcinoma

目的：通过分析子宫乳头状浆液性癌的临床病理特点，提出两种截然不同的子宫内膜癌的区别所在。方法：自１９８２年５月１日至１９９４年４月３０日，共收治子宫内膜癌１１０例，对其进行回顾性研究，并对其结果行统计学处理。结果：子宫乳头状浆液性癌１０例（占９．１％）。本病与普通子宫内膜癌的发病相关因素如高血压、糖尿病、肥胖、长期持续雌激素刺激等无关，且本病有较明显的淋巴转移倾向（５０％），分化明显不良（组织学分级３级占５０％），８０％的病例肌层浸润深度超过１／２肌层（Ｐ＜０．０１），有明显的宫外转移倾向（Ｐ＜０．０１），且术前分期不够准确。结论：本病在临床与病理学特点和普通子宫内膜癌截然不同，并且需要手术探查予以准确分期。

Objective:Tostudytheclinico-pathologicfeaturesofuterinepapilaryserouscarcino-maandpointoutthecompletediferencebetweenthetwokindsofendometrialcarcinoma.Methods:OnehundredandtencasesofendometrialcarcinomawhoreceivedtreatmentintheourhospitalfromMayl,1982toApril30,1994wereanalyzedretrospectively.Results:Ofthem,10cases(9.1%)ofuterinepapilaryserouscarcinoma(UPSC)werefound.Theageinaveragewas67.2yearsold,whichisnearly10yearsolderthanthosewithordinaryendometrialcancer(P<0.01).Theoc-currenceofUPSCwasrevealednorelationshipwiththerelativefactorsofoccurrenceofendometrialcarcinoma.Thestudyshowsthattumorhasverymarkedtendencyoflymphnodemetastasis,muchworsegrade,muchdeepermyometrialinvasionandmuchearlierextrauterinedisease.Conclusions:UPSCisaspecialpathologictypeofendometrialcarcinomawithcompletelydiferentclinico-patho-logicbehavior.ThesurgicalstagingisnecessaryforthepatientswithUPSCtogetcomprehensivestagebecausetheclinicalstageisusualynotcorrectenough.