子宫内膜癌宫体外转移相关临床病理因素分析

A correlative clinicopathologic factors analysis of outside uterine body metastasis in endometrial carcinoma.

目的:探讨子宫内膜癌宫体外转移相关的临床病理因素。方法:回顾分析2000年1月至2006年12月我院收治经手术治疗的196例子宫内膜癌患者的临床病理资料。根据有无转移将患者分为转移组和无转移组,再根据肌层浸润情况将患者分为3组,A组:无肌层浸润组;B组:浅肌层浸润组;C组:深肌层浸润组。比较分析转移组与无转移组患者的年龄、肌层浸润、肿瘤分化、病理类型的差异。结果:196例患者中有转移68例,无转移128例,有肌层浸润、中低分化、非子宫内膜样癌明显较无肌层浸润、高分化、子宫内膜样癌易发生转移,差异有统计学意义;年龄对转移无明显影响,差异无统计学意义;30例无肌层浸润者中1例发生盆腔淋巴结转移,166例有肌层浸润者中16例宫旁组织受侵。结论:子宫内膜癌是否发生宫体外转移与其分化程度、病理类型和有无肌层浸润密切相关;与年龄无关。无肌层浸润者也可能出现盆腔淋巴结转移,应考虑淋巴结活检或切除术。肌层浸润者宫旁组织可能受侵,应适当扩大手术范围。

Objective： To investigate the clinicopathologic factors of outside uterine body metastasis in endometrial carcinoma. Methods：To retrospectively review the clinicopathologic data of 196 patients after operation with endometrial carcinoma from Jan. 2000 to Dec. 2006. One hundred and ninety-six patients were divided into two groups by whether existed metastasis and three teams by myometrial invasion situation. The conditions of groups and teams were as follows, group 1 ： metastasis, group 2 ： no metastasis, team A ： without myometrial invasion, team B ： superficial myometrial invasion, team C ： deep myometrial invasion. The difference between the group 1 and group 2 patients in age, myometrial invasion situation, carcinoma cell differentiation situation ,and pathologic types were analyzed comparatively. Results：There were 68 patients exist metastasis in 196 patients. There were statistical difference between myometrial invasion, moderately or poorly level differentiated, non-endometrial carcinoma and non-myometrial invasion, well differentiated, endometrial carcinoma. The former occurred metastasis more easily than the latter. While the factor of age had no apparent effect on metastasis. One case occurred metastasis in 30 non-myometrial invasion patients, and 16 occurred tissue beside uterus invasion in 166 myometrial invasion patients. Conclusion： The metastasis of outside uterine body in endometrial carcinoma has close correlation with the pathologic type, myometrial invasion and differentiation level of carcinoma cell, but has no correlation with age. Non-myometrial invasion patients can occur pelvic lymph node metastasis and should consider lymph node biopsy or lymphadenectomy. Myometrial invasion patients maybe occur metastasis by side of uterus and should extend the scope of operation.