84例女性子宫内膜癌临床病理特点的研究

Clinicopathologic characteristic of endometrial cancer in 84 women

目的分析不同年龄子宫内膜癌患者的临床病理特点及预后,探讨年轻患者的理想治疗方案。方法对比分析本院1998年～2007年诊治的34例(年龄<40岁)子宫内膜癌患者(研究组)和50例(年龄≥60岁)子宫内膜癌患者(对照组)的临床病理资料及预后。结果研究组患者有高血压、糖尿病占2.9%,有子宫内膜癌家族史者占29.4%,均明显低于对照组(P<0.05)。研究组早期(I期)病例较多(88.2%),高于对照组(P<0.05)。组织病理类型以子宫内膜样腺癌为主(94.1%),非子宫内膜样腺癌少见,与对照组相比差异有显著性(P<0.05)。组织学分级为高中分化者占94.1%,浸润肌层深度<1/2或局限于内膜内者占72.4%,均高于对照组(P<0.05)。然而,研究组淋巴结转移率低于对照组,但5年生存率为93.7%,明显高于对照组(P<0.05)。结论子宫内膜癌年轻患者以子宫内膜样腺癌为主,临床分期早、预后好,多数患者能够长期生存。治疗应遵循个体化、人性化的原则,可以尝试保留其生育功能的手术。

[Objective]To analyze the clinicopathologic characteristic and prognosis of endometrial cancer patients in different age and explore the ideal treatment for young women.[Methods]34 cases （age 40 years） （study group） were compared with 50 patients （aged≥60 years） of endometrial cancer patients （control group） of clinicopathologic characteristic and prognosis. [Results]The study group had high blood pressure, diabetes accounted for 2.9%, family history of endometrial cancer accounted for 29.4%, which were all lower than control group （P 0.05）. The study group had more early period cases （I period） （88.2%）,which was higher than control group （P 0.05）. Histopathological types were mainly endometrial adenocarcinoma （94.1%） and rare in non-endometrioid adenocarcinoma in study group by contrast with the control group （P 0.05）. Histopathological grade for the high division, accounted for 2.9% in study group, was higher than control group （P 0.05）. Lymph node metastasis rate in study group was lower than control group. 5-year survival rate, accounted for 93.7% in study group, was distinctly higher than control group（P 0.05）.[Conclusion]Endometrial cancer in young patients has more endometrial adenocarcinoma , early clinical stage, good prognosis and long survival year in the majority of patients. So treatment should follow the individual and human-oriented principle, the surgical operations would be used to retain young women＇s reproductive function.