子宫内膜癌患者血雌激素水平与预后的关系探讨

Study on Estrogen Levels and Prognosis in Patients with Endometrial Carcinoma

目的 :探讨雌激素水平与子宫内膜癌的关系。方法 :对 92例绝经后子宫内膜癌的雌激素水平及其临床病理资料进行回顾性分析。结果 :92例患者中 ,高雌激素水平 (术前血浆雌二醇 >385pmol/L ,平均值 12 4 6 .9± 119.4 pmol/L) 58例 (6 3.0 4 % ) ,雌激素水平在正常范围 (术前血浆雌二醇 <385pmol/L ,平均值 192 .8± 12 8.9pmol/L) 34例 (36 .96 % ) ;前者伴发肥胖、高血压、糖尿病明显高于后者 (P <0 .0 5) ,且前者临床期别早 ,组织学改变以子宫内膜增生常见 (P <0 .0 5) ,细胞分化好 ,肌层浸润及宫颈转移前者显著低于后者 (P <0 .0 5) ;5年生存率前者 91.38% ,后者 73.53% ,二者有显著差异 (P <0 .0 5)。结论 :子宫内膜癌存在两种类型 ,Ⅰ型为雌激素相关型 ,Ⅱ型为非雌激素相关型。

Objective:To investigate the relationship between estrogen and endometrial carcinoma.Methods:In a retrospective study,the estrogen level and the clinical and pathological data from 92 patients with endometrial carcinoma were analyzed. Results:It was shown that the estrogen level increased in 58 cases (63.04%) (Group A)(1246.9±119.4pmol/L) and was normal in 34 cases (36.96%) (Group B)(192.8±128.9pmol/L). The prevelance rates of obesity,hypertension and diabetes were higher in patients with increased estrogen (P<0.05). Most of the cases with higher estrogen were at the earlier stage of the cancer,and endometrical hyperplasia was the common histological change(P<0.05). Muscular infiltration and servical metastasis of the cancer was significantly lower in group A than that in group B (P<0.05). 5-year survival rate was 91.38% and 73.53% in group A and B respectively,and the difference was significant(P<0.05). Conclusion:There are two types of endometrial carcinoma ,type one is correlated with estrogen,with the better prognosis.