摘要
[目的]探讨子宫恶性苗勒氏管混合瘤(MMT)的诊断与治疗,寻求改善预后的方法。[方法]回顾性分析1963年10月至1997年10月收治的21例子宫MMT的临床资料。[结果]子宫MMT无特异临床表现,术前诊断困难,必须重视术前诊刮、宫颈口结节活检及术中冰冻检查。单纯手术6例,手术加化疗10例,手术加放疗和化疗3例。总的2年、5年生存率为57%和 30%,Ⅰ和 Ⅱ期 5年生存率分别为 45.4%和 9%,Ⅲ和 Ⅳ期病人均于 2年内死亡。子宫小于 3个月妊娠, 5年生存率为46%,大于3个月妊娠为25.5%,绝经前与绝经后的5年生存率分别为33%和21.4%。[结论]预后与临床期别、病理类型、子宫大小、绝经情况和治疗方法等相关。治疗以手术为主,术后辅以化疗可减少和延缓肿瘤复发和转移。化疗和放疗对治疗局部复发和远处转移有一定疗效。
Purpose] To study the clinical data of uterine Mullerian Tumors (MMT) in 21 cases and try to find the better way to improve overall survival as well as diagnosis and treatment. [Methods] To retrospectively evalute prognostic factors and treatment modalities. [Result] There were no special clinical signs and symptoms for uterine MMT.Six cases underwent surgery alone; 10, surgery plus postoperative chemotherepy; 3, surgery plus chemotherapy and irradiation.The overall 2 - year and 5 - year survival rate was 57% and 30% respectively.The 5 - year survival rate for stage Ⅰ and Ⅱ was 45 .4% and 9% respectively. All Patients of stage Ⅲ and Ⅳ died within 2 years. When the uterus was smaller than or larger than the size of 3 months pregnant uterus, the 5 - year survival rate was 46% and 25.5% respectively. The 5 - year survival rate in premenopause and postpause was 33% and 21 .4% respectively. [Conclusion] The prognosis of uterine MMT is close related to clinical stage, histologic type, uterine size, pre- or post- menpausalas status and primary treatment. The mainstay of the treatment is surgery. Postoperative chemotherapy can decreased recurrence and matastasis. Chemotherapy and irradiation is of benefit to those recurrent and matastatic cases.
关键词
子宫肿瘤
癌肉瘤
中胚中混合瘤
预后
Uterine neoplasms Carcinosarcoma Mixed mesodermal sarcoma Mixed Mullerian tumor Prognosis