子宫内膜癌FIGO 2009分期中Ⅰ期的临床意义

Clinical significance of FIGO 2009 staging Ⅰ and its prognostic related factors in endometrial carcinoma

目的 探讨子宫内膜癌国际妇产科联盟2009年（FIGO 2009）分期中Ⅰ期的临床意义.方法 收集北京大学人民医院1998年12月至2009年12月间收治的FIGO 2009分期为Ⅰ期,随访资料较完整且行全面分期手术的子宫内膜癌患者233例,FIGO 2009分期中将FIGO 1988分期中的Ⅰ a期及Ⅰb期归为Ⅰa期,Ⅰc期归为Ⅰb期,将子宫颈腺体受累（Ⅱa期）归为Ⅰ期并根据其肌层浸润深度确定归为Ⅰa期或者Ⅰb期,取消FIGO 1988分期中的Ⅰ c期.对照FIGO 1988分期,回顾性分析与FIGO 1988分期相关的临床病理因素.结果 233例FIGO 2009分期为Ⅰ期的子宫内膜癌患者中,FIGO 1988分期为Ⅰa期41例、Ⅰb期146例、Ⅰc期29例、Ⅱa期17例.对FIGO 1988分期中Ⅰa期、Ⅰb期进行分析显示,病理分级、病理类型、脉管内癌栓、ER、PR表达、术后化疗及术后放化疗与Ⅰa期、Ⅰb期分期均无明显相关性（P均＞0.05）;而肌层浸润深度与Ⅰ a期、Ⅰb期分期密切相关（P=0.000）.对FIGO 1988分期中Ⅰ期、Ⅱa期进行分析显示,病理分级、病理类型、脉管内癌栓、肌层浸润、ER、PR表达、术后化疗及术后放化疗与Ⅰ期、Ⅱa期分期均无明显相关性（P均＞0.05）.结论 子宫内膜癌FIGO 2009新分期中的Ⅰ期较FIGO 1988分期中的Ⅰ期和Ⅱa期更符合患者的实际临床状况.

Objective To discuss the clinical significance of Federation International of Gynecology and Obstetrics （FIGO） 2009 staging Ⅰ and its prognostic related factors in endometrial carcinoma.Methods A retrospective analysis was carried out on 233 cases with FIGO 2009 staging Ⅰ endometrial carcinoma who were admitted to Department of Obstetrics and Gynecology,Peking University People＇s Hospital from Dec.1998 to Dec.2009 and were carried with complete staging operation then compared with FIGO 1988 staging.All follow-up data were complete.Results Of the 233 cases,including FIGO 1988 staging Ⅰ a 41 cases,Ⅰ b 146 cases,Ⅰ c 29 cases and Ⅱ a 17 cases.The univariate analysis revealed that there were no significant difference between staging Ⅰ a and Ⅰ b group in histological grade,pathological type,intravascular vessel cancer embolus,the expression of ER,PR,postoperative chemotherapy or postoperative chemoradiotherapy （all P〉0.05）.The univariate analysis revealed that there were no significant difference between staging Ⅰ and Ⅱ a group in histological grade,pathological type,intravascular vessel cancer embolus,the depth of myometrial invasion,the expression of ER and PR postoperative chemotherapy or postoperative chemoradiotherapy （all P〉0.05）.Conclusion FIGO 2009 staging Ⅰ in endometrial carcinoma is more consistent with the patient＇s clinical status than that in FIGO 1988 stage Ⅰ and Ⅱa.