Ⅰ型和Ⅱ型子宫内膜癌临床病理特点对比分析

Comparative analyses of clinical and pathological characteristics between types 1 and 2 endometrial uterine cancers

目的 探讨Ⅰ型和Ⅱ型子宫内膜癌的临床病理特点.方法 回顾性分析2000年1月至2010年12月广东省子宫内膜癌防治项目协作医院子宫内膜癌的临床资料,并依据组织学类型分成Ⅰ型子宫内膜癌（9 138例）和Ⅱ型子宫内膜癌（299例）两组,进行对比分析.结果 Ⅰ型子宫内膜癌患者发病年龄低于Ⅱ型（P＜0.05）,年轻患者比例高于Ⅱ型（P＜0.05）.Ⅱ型子宫内膜癌患者绝经年龄高于Ⅰ型（P＜0.05）.Ⅰ型和Ⅱ型子宫内膜癌在初潮年龄以及合并肥胖、糖尿病、高血压、不孕、未产方面比较差异均无统计学意义（P＞0.05）.Ⅱ型子宫内膜癌的晚期（Ⅲ期和Ⅳ期）、深肌层浸润、雌激素受体（ER）阴性、孕激素受体（PR）阴性、P53阳性、淋巴脉管间隙受累、宫颈间质浸润、腹水细胞学阳性、附件转移、淋巴结转移的发生率高于Ⅰ型（P＜0.05）.结论 Ⅱ型子宫内膜癌患者年龄较大,病理危险因素多,生物学恶性程度高.

Objective To investigate the clinical and pathological characteristics between types 1 and 2 endometrial uterine cancers.Methods The clinical materials of 9 437 patients with uterine cancer were collected with retrospective analysis from 62 hospitals during 2000 to 2010.Results The mean age of type 1 endometrial cancers was less than type 2.There were more young patients in type 1 endometrial cancers.The mean menopause age of type 2 endometrial cancers was greater than type 1.The mean age of menarche,obesity,diabetes,hypertension,infertility,and nulliparous were not significant differences between types 1 and 2 endometrial cancers.There were more patients with advanced tumor,deep myometrium invasion,estrogen receptor （ERs） negative,progesterone receptor （PR） negative,P53 positive,lymph vascular space involvement,cervical stromal invasion,adnexal metastasis,and lymph node metastasis in type 2 endometrial cancers.Conclusions Type 2 endometrial uterine cancers occurred in elder people with more pathological risk factors and more malignant biological activities.