子宫内膜腺鳞癌51例临床预后分析

Clinical analysis of 51 cases with adenosquamous carcinoma of the endometrium

目的通过对子宫内膜腺鳞癌临床特征的分析，探讨影响预后的因素。方法回顾性研究1997年7月至2007年5月湖南省肿瘤医院共收治51例子宫内膜腺鳞癌病人。结果①腺鳞癌占同期全部宫内膜癌的4．78％，腹膜后淋巴结转移率14．0％。②肌层浸润〈1／2与〉1／2的宫外转移率分别为26％和62．5％，差异具有显著性（P〈0．05）。③单因素线性回归分析显示：腺癌分化程度与浸润肌层深度有关（P=0．035）。④Ⅰ期5a生存率85．7％，Ⅲ期5a生存率66．7％，而Ⅳ期2a生存率分别为33．3％。结论子宫内膜腺鳞癌临床特征与普通子宫内膜样腺癌无明显区别。分化程度和肌层浸润深度是影响其预后的重大因素。

Objective To study the clinical characteristics and prognosis for adenosquamous carcinoma of the endometrium. Methods 51 cases with pathologically confirmed endometrium adenosquamous carcinoma from Jan 1997 to May 2007 were retrospectively analyzed. Results Among the endometrium adnocarcinoma patients, 4.78% were adenosquamous carcinoma, lymph note metastases rate was 14.0%. Distant metastases who had deep myometrium infiltration and those who hadn＇t were 26% and 62.5%, respectively （P〈0.05）. Linear-regression analysis showed pathologic grade of adenocarcinoma was correlated with depth of muscularis invasion （P=0.035）. The 5-year overall survival was 85.7% in stage Ⅰ, 66.7% in stage Ⅲ while the 2-year overall survival was 33.3% of endometrium adenosquamous carcinoma in stage Ⅳ. Conclusions The clinical characters and prognosis of endometrium adenosquamous carcinoma might be similar to other endometrioid carcinomas. The pathologic grade and depth of muscularis invasion could be important factors which affect the prognosis.