子宫内膜癌110例临床病理分析

A CLINICOPATHOLOGIC STUDY OF110 CASES OF ENDOMETRIAL CARCINOMAS

对手术根治的１１０例子宫内膜癌进行了临床病理分析，并对术后生存５年以上的５６例进行了预后因素的探讨。１１０例平均发病年龄为５９．８岁，平均绝经年龄为５０．２岁，月经紊乱（２３．６％）、不孕（２８．２％）、肥胖。高血压－糖尿病（３４．６％）及并发卵巢多个滤泡囊肿（３２．７％）的发生率较高，表明长期持续的、缺乏孕酮对抗的雌激素刺激与发病相关。随访５６例，５年生存率为８３．９％，其中临床Ⅰ、Ⅱ期５年生存率为１００％，Ⅲ期为４２．９％，Ⅳ期为０，提示癌组织局限在子宫内时预后佳，扩散至子宫外者预后差。

A clinicopathologic analysis of 110 cases with endomtrial carcinomas was performed and all cases were treated with radical operation . The prognostic factors were discussed in 56 cases that survived more than 5 year period after. operation. The mean age of the patients was 59.8 years and the mean menopausal age was 50 years. The incidence of irregular menstrual cycles ( 23.6% ) , infertility ( 28. 2%) , obseity-hypertention-diabet ( 34. 6%) and polycystic ovary(32.7%) were higher. The depths of myometrial invasion , histological grades and metastasis were all associated with prognosis significantly (P< 0. 05 ) . The 5 year survival rate of all patients is 83.9% and 100% in clinical stage Ⅰand Ⅱ, 42. 9% in stage Ⅲ and 0 in stage Ⅳ . The data presented here show: the occurrence of the disease is related to long-term and continuou. estrogen stimulation which is unopposed by progesterone. The depths of myometrial invasion , histological grades and metastasis are important prognostic indictors. ,The prognosis is good if the tumor tissue limited in the uterus and once it spreads out of the uterus the prognosis becomes very poor.