138例非内膜样子宫内膜癌的临床病理分析

Clinical and pathological analysis of 138 patients with non-endometrioid carcinoma of endometrium.

目的 探讨非内膜样子宫内膜癌的更合适治疗方式。方法 收集 2 0年来经我院治疗的非内膜样子宫内膜癌 138例 ,比较 5种病理亚型的肌层浸润、累及宫颈、子宫外扩散、脉管浸润及 1年、3年、5年存活率情况。结果 19例粘液腺癌及 5 6例角化腺癌的 5年存活率均达到 10 0 % ,说明该两种病理类型具有较低的恶性生物学行为 ;而 38例鳞腺癌、2 0例透亮细胞癌、4例浆液乳头状腺癌的 5年存活率依次为 76 31%、72 2 2 %及 40 0 0 % ,可能与该三类肿瘤较易发生深肌层浸润、子宫外扩散及脉管浸润有关。

Objective To explore more appropriate treatment for non-endometrioid carcinoma of endometrium.Methods 138 patients of 5 sub-pathologic types of non-endometrioid carcinoma of endometrium were collected during late 20 years in our hospital.The infiltration of myometrium,cervical,vessels and the spreading beyond uterus as well as survival rate of 1,3,5 years were analyzed, retrospectively.Results The 5-year-survival rate of 19 patients with mucinous adenocarcinoma and 56 patients with adenoacanthoma was 100%,which suggested that the two sub- pathologic types had less malignant biological activity .Whereas that of 38 patients with adeno-squamous carcinoma,20 patients with clear cell carcinoma and 4 patients with papillary serous carcinoma were 76 31%,72 22% and 40%,respectively.This might be due to their tendency to invade deep myometrium ,spread beyond uterus and vascular space invasion .Conclusion Different surgical range and assistant therapy should be selected according to different sub- pathologic type of non-endometrioid carcinoma of endometrium.