子宫癌肉瘤29例临床分析

Clinical analysis of twenty-nine cases of uterine carcinosarcoma

目的探讨子宫癌肉瘤的临床特点、治疗及预后相关因素。方法回顾性分析我院1998年7月～2007年11月收治的29例子宫癌肉瘤的临床资料并对29例患者进行随访。结果29例子宫癌肉瘤患者中,宫颈癌肉瘤2例,宫体癌肉瘤27例。主要临床表现为不规则阴道流血和阴道异常排液。确诊需要依据病理组织检查。29例患者均接受手术,其中14例术后辅助化疗,2例术后辅助放疗,6例术后联合放化疗。2例宫颈癌肉瘤中1例于术后53个月复发死亡,1例随访至今30个月无瘤生存。27例宫体癌肉瘤1、3、5年生存率分别为71.4%、37.0%、26.0%。结论手术是子宫癌肉瘤的主要治疗方法,预后与手术病理分期、治疗方式有关,治疗上以手术治疗为主,术后辅以放化疗,以提高患者生存率。

Objective To investigate the clinical manifestation,treatment and prognostic factors of uterine carcinosarcoma.Methods Clinical data of 29 uterine carcinosarcoma patitents,diagnosed in Jiangxi matemal and child health hospital from July 1998 to November 2007,were analyzed.Results In the 29 cases of uterine carcinosarcoma,2 were in the cervix,27 in the corpus uteri.The main clinical manifestation was abnormal vaginal bleeding and vaginal fluid.Diagnosis depended on pathology .twenty-nine patients undergone operation .fourteen patients received chemotherapy,two patients received radiotherapy,and six patients received radiotherapy and chemotherapy combined after operation.One cervical carcinosarcoma patient died withen fifty three months.The other has been kept disease free survival so far thirty months.The 1-,3-,5-year survival rates of the 27 patients were 71.4%,37.0% and 26.0% respectively.Conclusion Primary surgery is the main treatment for uterine carcinosarcoma .The prognosis of uterine carcinosarcoma is associated with surgicopathologic stage and treatment modalities.Surgery is the mainly treatment,received radiotherapy and chemotherapy after surgery to improve survival in patients.