45岁以下子宫内膜癌40例临床分析

Clinical analysis of 40 cases of endometrial carcinoma no older than 45 years old

目的探讨45岁以下子宫内膜癌的临床特点。方法对2000年12月至2004年12月间中山大学附属第三医院、中山大学附属第二医院及中山大学附属肿瘤医院妇科收治的189例子宫内膜癌进行回顾性分析,其中≤45岁组40例,>45岁组149例,比较两组患者的临床特点。结果≤45岁组中原发不孕14例(35.0%),>45岁组中原发不孕4例(2.7%),两组比较,差异有统计学意义(P<0.05);≤45岁组妊娠次数<3次者28例(70.0%);>45岁组妊娠次数<3次者47例(31.5%),两组比较,差异有统计学意义(P<0.05)。两组肌层浸润程度比较,差异有统计学意义(P<0.05);手术病理分期、病理类型、组织学分级、淋巴转移和附件转移比较,差异无统计学意义(P>0.05);≤45岁组的平均生存时间为(77.7±2.5)个月,平均复发时间为(75.2±2.8)个月;>45岁组的平均生存时间为(76.0±2.2)个月,平均复发时间为(71.4±2.5)个月;两组患者的生存时间、复发时间比较,差异无统计学意义(P>0.05)。结论不孕少孕是45岁以下子宫内膜癌患者的高危因素,45岁以下子宫内膜癌患者较少发生肌层浸润,预后与大于45岁的患者相似。

Objective To summarize the clinical characteristics of endometrial carcinoma patients who were no older than 45 years old. Methods The clinical characteristics of 189 cases of endometrial carcinoma who were treated in the Third Affiliated Hospital of Sun Yat - Sen University, the Second Affiliated Hospital of Sun Yat - Sen University and Sun Yat - Sen University Cancer Center from December, 2000 to December, 2004 were analyzed retrospectively. Patients were invided into two groups according to age. Group I was ≤45 years old and group Ⅱ was〉45 years old. Clinical characteristics of the two groups was compared. Results There were 14 cases （35.0%） of in- fertility and 28 cases （70.0%） whose pregnant times less than three in group I, while there were 4 cases （2. 7%） and 47 cases （31.5 %） in group ]l, respectively. The difference was significantly （P 〈 0.05 ）. There was signifficant difference of the myometrial invsion depth in the two groups （P〈0. 05）. There were no significant difference of surgical- pathologic stage, pathologic type, histologic grade, adnexal metastasis and lymph node metastasis in the two groups （P〉0. 05）. In group I the average survival time was （77.7!2.5） months and the average recurrence time was （75.2±2.8） months, as groupⅡ, it was （76.0±2. 2） months and （71.4±2.5） months, respectively. The survival curves and alleviate curves were comparable in the two groups. There were no significant difference of both survival curve and alleviate curve in the two groups （P〉0.05）. Conclusion Sterility and less pregnant times are high risk factors for endometrial carcinoma patients aged 45 years or younger. Myometrial invasion in younger patients was less than that in elder ones. The prognosis of younger patients were the same as the old ones.