子宫内膜腺鳞癌临床病理特征及其预后研究

Clinical analysis of the clinical pathological characters and prognosis of the adenosquamous carcinoma of the endometrium

目的探讨子宫内膜腺鳞癌患者的临床病理特征及预后。方法选取1992年3月至2004年12月北京大学人民医院就诊的子宫内膜癌患者,分为普通子宫内膜样腺癌组、腺鳞癌组以及浆液性乳头状腺癌和透明细胞癌组进行回顾性研究。结果腺鳞癌患者9例,占同期210例内膜癌患者的4.3%。普通子宫内膜样腺癌组与腺鳞癌组肿瘤分期差异无显著性意义(P>0.05);浆液性乳头状腺癌和透明细胞癌患者肿瘤分期明显晚于子宫内膜样腺癌患者(P<0.05)。腺鳞癌组深肌层及浆膜层浸润较普通子宫内膜样腺癌组多,分别为6/9和32.6%(62/190),但差异无显著性意义(P>0.05)。腺鳞癌组与普通子宫内膜样腺癌组患者肿瘤细胞分化程度差异无显著性意义(P>0.05)。18例(9.5%)普通子宫内膜样腺癌患者、1例(1/9)腺鳞癌患者以及4例(4/11)浆液性乳头状腺癌和透明细胞癌患者因癌死亡,子宫内膜样腺癌患者因癌死亡比例明显低于浆液性乳头状腺癌和透明细胞癌患者(P<0.05),而普通子宫内膜样腺癌组与腺鳞癌组差异无显著性意义(P>0.05)。生存分析显示接受手术治疗的腺鳞癌患者,其预后与肿瘤分期相关(P<0.05)。结论子宫内膜腺鳞癌临床病理特征及预后与普通子宫内膜样腺癌无明显区别,而与浆液性乳头状腺癌和透明细胞癌不同。

Objective To explore the clinical pathological characters and prognosis of the adenosquamous carcinoma of the endometrium. Methods A retrospective study was carried out in 210 cases of endometrial carcinoma who were admitted to our department from Mar, 1992 to Dec, 2004. The patients were divided into endometrioid carcinoma group, adenosquamous carcinoma group and UPSC and CCC group. Results Among the 210 endometrial carcinoma cases, there were 9cases of adenosquamous carcinoma （4. 3% ）, The stage of the endometrioid carcinoma group and adenosquamous carcinoma group did not differ much （ P 〉 0. 05 ）, The stage of the UPSC and CCC group was later than the endometrioid carcinoma （（P〈0. 05）. There were 32. 6% and 6/9 cases who had deep myometrium infiltration in the endometrioid carcinoma group and adenosquamous group respectively, But there was no statistical difference （ P 〉 0. 05 ）. The grading of the endometrioid carcinoma group and adenosquamous carcinoma group did not differ much （ P 〉 0. 05 ）. There were 18 cases （9. 5% ）, 1 case （1/9） and 4 cases （4/11） who died due to the carcinoma in the endometrioid carcinoma group, adenosquamous carcinoma group and UPSC and CCC group, respectively. The death rate of the endometrioid carcinoma patients was remarkably lower than the UPSC and CCC group （ P 〈 0. 05 ）. However, the death rate between the endometrioid carcinoma group and adenosquamous carcinoma group did not differ much （ P 〉 0. 05 ）. The survival analysis showed that the staging was related to the prognosis of the adenosquamous carcinoma patients who had been treated with surgery. Conclusion The clinical pathological characters and prognosis of the adenosquamous carcinoma of the endometrium are similar to other endometrioid carcinomas. But they all differ remarkably from the UPSC and CCC patients.