子宫浆液性癌与低分化子宫内膜样腺癌临床病理特征及预后比较

A Clinical Comparison between Uterine Serous Carcinom a and Grade3 Endometroid Endometrial Carcinomas

目的:探讨子宫浆液性癌(USC)和低分化子宫内膜样腺癌(G3EEC)的临床病理特征和预后差异。方法:回顾性分析广东省子宫内膜癌防治项目2000年1月1日至2010年12月31日收治的101例USC患者和619例G3EEC患者,比较两者的临床、病理特征、免疫组化结果和预后。结果:1USC组和G3EEC组的发病年龄、未产、糖尿病、高血压、肥胖、首发症状(异常子宫出血)、临床分期Ⅲ或Ⅳ期比较,差异均无统计学意义(P>0.05);2手术病理分期Ⅲ或Ⅳ期、临床Ⅰ期术后分期升高、肿瘤局限于宫腔下部、深肌层浸润、腹水细胞学阳性、宫颈间质浸润、淋巴结转移以及大网膜转移比例比较,差异均无统计学意义(P>0.05);3雌激素受体、孕激素受体、人类表皮生长因子受体2阳性率比较,差异无统计学意义(P>0.05),USC组P53阳性率(86.2%)高于G3EEC组患者(53.4%),差异有统计学意义(P<0.05);45年总体生存率和无进展生存率,USC组患者分别为74.9%和67.9%,G3EEC组患者分别为78.4%和70.1%,差异无统计学意义(P>0.05)。结论:G3EEC患者与USC患者的临床病理特征和预后具有较多相似点,临床上应重视G3EEC的诊治与随访。

Objective： To compare the clinicopathological features and prognosis of patients with uterine serous carcinoma（ USC） and grade3 endometrioid endometrial cancer（ G3EEC）. M ethods： 101 patients with USC and619 with G3 EEC who were included in a multicenter study of endometrial cancer prevention projects in Guangdong Province between 2000 and 2010 were retrospectively studied. Analysis was performed to compare their clinicopathological features and prognosis. Results： 1There were no significant differences in the mean age,proportion of nullparity,diabetes mellitus,hypertension,obesity and initial symptoms,clinical stage between two groups（ P 〉0. 05）. 2The proportion of advanced surgical stage,the patients with clinical stage Ⅰ who were upstaged after surgery,tumors confined to lower segment of uterus,deep myometrial invasion,positive washings,cervical stromal invasion,lymph node metastasis and omentum metastasis also featured no significant differences（ P 〉0. 05）. 3 No significant differences were found in estrogen receptor,progestrone receptor,human epidermal growth factor receptor 2 expression between USC and G3 EEC,while USC had a higher rate of P53 expression than G3EEC（ 86. 2% vs 53. 4%,P〈0. 05）. 4The 5-year overall survival for USC and G3 EEC were 74. 9% and78. 4%,respectively and 5-year progress free survival were 67. 9% and 70. 1%,respectively（ P 〉0. 05）. Conclusions： G3 EEC and USC share similar clinicopathological features and outcomes,so we should pay more attention to clinical diagnosis and treatment and follow-up of G3 EEC.