Ⅰ期子宫内膜癌扩大手术范围问题（附186例手术分析）

Problem on extensive surgical range of stage Ⅰ endometrial carcinoma:A surgical analysis of 186 cases

１８６例子宫内膜癌手术中，１０５例扩大了手术范围，研究发现，Ⅰ期癌盆腔淋巴结转移率为１１．６７％，其中Ⅰａ期无淋巴结转移，Ⅰｂ期盆腔淋巴结转移率为８．８２％，Ⅰｃ期则高达２１．０５％。故子宫内膜癌肌层浸润是盆腔淋巴结转移的重要因素。因肌层浸润深度可经Ｂ超、ＣＴ、ＭＲＩ等于术前确知，故术前临床分期宜选ＵＩＣＣ分期。凡有子宫肌层浸润的Ⅰ期癌均应扩大手术范围，这也符合１９８８年ＦＩＧＯ新临床手术分期的要求。

Having analyzed extensive surgical range of 105 cases of endometrial carcinoma, we found that the incidence of positive pelvic nodes in stage Ⅰ endometrial carcinoma was 11.67%. Among which, there was no pelvic nodes involvement in stage Ⅰa, and the incidence of positive pelvic nodes in stage Ⅰb was 8.82%, stage Ⅰc 21.5% . Myometrial invasion of endometrial carcinoma took an important role in pelvic lymph node metastasis . In preoperative clinical staging, UICC staging criteria should be adopted, since myometrial invasion deepness can be ascertained by applying modern diagnostic techniques, such as ultrasound, CT and MRI. It is necessary and aslo feasible to perform extensive operations for the stago Ⅰ patients with myometrial invasion. This accords with the surgical demand of FIGO new clinical staging system issued in 1988.