子宫内膜癌诊治进展

The Advancement in Diagnosis and Therapy of Endometrial Cancer

子宫内膜癌(endometrial cancer,EC)是女性常见的恶性肿瘤之一,近年发病率有明显上升趋势,因此其诊治理念也不断更新。首先,在临床诊断与分期方面,宫腔镜、超声及腹腔细胞学等检查的意义增加。宫腔镜检查有利于发现微小病灶并定位活检,已成为诊断子宫内膜癌重要手段;超声及腹腔细胞学检查对肿瘤分期及预后判断有较大意义。其次,腹腔镜手术对早期子宫内膜癌治疗显示良好应用前景;放化疗、激素治疗等辅助疗法对中晚期及复发性子宫内膜癌有一定疗效。最后,保留生育功能的观念不断更新。在保证治愈率前提下,尽可能保留女性生育功能已成为妇科肿瘤治疗新理念,反复子宫内膜诊刮及孕激素治疗早期子宫内膜癌已有不少报道。

Endometrial cancer is one of the most common malignancy in women.The concept of diagnosis and treatment of endometrial cancer renovates obviously, due to the increases of the disease incidence. First of all, hysteroscopy, ultrasound and peritoneal cytology examination represent a gradually increasing insignificance in clinical diagnosis and staging area. Hysteroscopy in favor of finding tiny lesions, has become an important means of diagnosis of endometrial cancer. Ultrasound and peritoneal cytology examination have a greater significance to determine staging and prognosis of the tumor. Secondly, laparoscopic surgery shows a good prospect in the early treatment of endometrial cancer. Radiotherapy, chemotherapy and hormone therapy have certain effects for advanced and recurrent endometrial cancer. Finally, the concept of preserving reproductive function updated continuously. Reserving of female reproductive function as far as possible has become a new concept of the treatment of gynecological tumor at the premise of ensuring the cure rate. There are many reports of repeated endometrial curettage and progesterone treatment of early endometrial cancer.