观察子宫内膜癌介入治疗前后的病理学改变

Observation on the pathological changes in endometrial carcinoma between before and after interventional therapy

目的探究子宫内膜癌患者在介入治疗前后的临床病理学变化情况。方法选择2014年4月至2016年4月成都肛肠专科医院院收治的子宫内膜癌患者18例,均接受介入治疗,行盆腔动脉灌注化疗栓塞治疗。治疗前后,对患者的癌组织病理学变化情况进行观察记录。结果 18例入组患者一共接受22例次术前化疗,其中14例患者在术后2周～3周的时间内接受子宫内膜癌根治术治疗,术中出血少。2例Ⅳ期患者在完成2次介入治疗之后,失去手术机会;其余2例Ⅳ期患者在阴道出血成功止血之后45d死亡,死亡原因为脑转移。18例子宫内膜癌患者中,14例患者在完成1个～2个疗程的介入治疗之后接受手术治疗,术中获得病理标本。术后对病理标本送检,进行详细的病理学检查。可得其中10例患者的术后标本病理切片中存在大量坏死组织以及淋巴细胞浸润现象,未观察到癌细胞,提示组织学完全缓解。另外有2例患者病理检查结果显示癌细胞绝大部分坏死,仅观察到存在极少数残存变异的癌细胞,其余2例癌组织部分坏死。结论对子宫内膜癌患者实施介入治疗可以获得理想的治疗效果,临床病理学会出现一定的改变,部分患者可实现组织学完全缓解。

Objective To investigate the pathological changes of endometrial cancer patients between before and after interventional therapy.Methods 18 patients with endometrial cancer treated in our hospital from April 2014 to April 2016 all received interventional therapy,and were treated with pelvic arterial infusion chemotherapy and embolization.The pathological changes of the patients were observed and recorded before and after treatment.Results 18 patients received a total of 22 times of received preoperative chemotherapy.14 patients received radical resection of endometrial carcinoma at 2~3 weeks postoperative with less bleeding.2 patients at stage IV lost operative chance after completing twice interventional treatment.The remaining 2 patients at stage IV died of brain metastasis within 45ds after successful hemostasis of vaginal bleeding.14 patients received surgical treatment after 1~2 courses of interventional therapy,and pathological specimens were obtained during the operation.Detailed pathological examination was carried out after operation.There were lots of necrotic tissue and lymphocyte infiltration phenomenon in the postoperative biopsy specimens of 10 patients without cancer cells,suggesting complete pathological remission.the vast majority of cancer cells were observed dead in another 2 patients with a handful of surviving cancer variants,and partial cancer tissue necrosis was observed in the remaining 2 cases.Conclusions Interventional therapy can achieve ideal therapeutic effect for endometrial cancer patients,with some clinical pathologic changes,and some patients can achieve complete remission.