子宫透明细胞癌25例临床病理特征及预后因素分析

Clinicopathological characteristics and prognostic factors of 25 cases of uterine clear cell carcinoma

目的探讨子宫透明细胞癌的临床病理特征及预后因素。方法回顾性分析北京大学人民医院14年间共25例子宫透明细胞癌患者的临床病理资料。结果①25例患者中,Ⅰ期15例,Ⅱ期4例,Ⅲ期5例,Ⅳ期1例;②25例患者均行手术治疗,其中2例早期病例行筋膜外全子宫+双附件切除术,余早期病例均行全面分期术,晚期病例均行肿瘤细胞减灭术,其中术后19例接受铂类为基础的联合化疗;③预后因素分析提示,盆腔和(或)腹主动脉旁淋巴结阳性是子宫透明细胞癌患者预后独立危险因素。结论子宫透明细胞癌多可早期发现,经全面分期术辅以术后化疗,预后良好。子宫透明细胞癌若伴有淋巴结转移或浆液性成分预后差。

Objective To investigate the clinicopathological characteristics and prognostic factors in women with uterine clear cell carcinoma(UCCC). Methods The clinicopathological data of 25 patients with UCCC in Peking University People’s Hospital during 14 years were retrospectively analyzed. Results ① FIGO staging of 25 cases: stageⅠ15 cases, stage Ⅱ 4 cases, stage Ⅲ 5 cases, stage Ⅳ one case. All 25 patients underwent surgical treatment, of which 2 early stage cases underwent total extrafascial hysterectomy and bilateral salping-oophenrectomy, the others underwent comprehensive surgicalstaging, while the advanced underwent cytoreductive surgery. 19 patients received platinum-based combined chemotherapy. The analysis of prognostic factors indicated that lymph node positivity was an independent high-risk factor for the prognosis of UCCC. Conclusion Uterine clear cell carcinoma could be found at early stage. The prognosis is good when given adjuvantchemotherapy after comprehensive surgery, but it is poor while accompanied by serous carcinoma component or lymph node metastasis.