绝经前与绝经后子宫内膜癌的临床病理特征分析

Analysis on the clinicopathologic characteristics of endometrial carcinoma in premenopause and postmenopause

目的 分析绝经前与绝经后子宫内膜癌的临床特点及病理特征。方法 根据患者绝经与否将我院 1986～ 2 0 0 0年间住院治疗的 6 9例子宫内膜癌患者分为绝经前组与绝经组 ,并对两组的B超诊断与病理诊断结果的符合情况、临床特点及病理特征进行回顾性分析。结果 两组患者的临床表现中除绝经前患者以阴道大量出血为主 ,与绝经后的比较 ,差别有显著性意义 (P <0 0 1)外 ,余表现两组间差别均无显著性意义 (P >0 0 5 )。两组病理特征比较除临床分期两组间差别无显著性意义 (P >0 0 5 )外 ,两组间病理类型、细胞分化和肌层浸润程度的比较 ,差别均有显著性意义 (P<0 0 5～ 0 0 0 1)。 33例绝经前患者中有 15例B超诊断与术后病理诊断相符 ,14例不相符 ,漏诊率为42 4% ;绝经后患者 36例中 2 4例相符 ,7例不相符 ,漏诊率为 19 4%。结论 绝经前子宫内膜癌易漏诊 ;绝经后子宫内膜癌恶性程度高 ,分化差 ,肌层浸润深 ,易发生转移。

Objective To analyze the clinicopathologic characteristics of endometrial carcinoma in premenopause and postmenopause.Methods 69 patients with endometrial carcinoma in our hospital from Jan.1986 to Dec.2000 were divided into two groups (patients in premenopause and in postmenopause) and the clinicpathologic characteristics of two groups were analyzed retrospectively.Results Among 33 patients in premenopause,15 patients were diagnosed by ultrasonography,14 were misdiagnosed(42.4%).Among 36 patients in postmenopau,24 cases were diagnosed by ultrasonography,7 were misdiagnosed(19.4%).There were 6 cases in premenpause and 11 case in postmenpause over clinic-stage II.There were 6 cases in premenpause and 11 case in postmenpause of patho-histological grades over G3.There were 2 cases in premenpause and 15 case in postmenpause invasiving ultermucle over 50%.Conclusion The endometrial carcinoma in premenpause could be misdiagnosed easily.The malignant degree of endometrial carcinoma in postmenpause is higher and its differentiation is lower,infiltration in myometrium deeper.The endometrial carcinoma in postmenpause is easy to be metastasized.