1990~2020年北京市1721例子宫内膜癌临床病理分析

Clinicopathological analysis of 1721 cases of endometrial carcinoma in Beijing from 1990 to 2020

目的分析北京市两家医院30年间收治的京籍子宫内膜癌的病例,探讨子宫内膜癌的发病年龄、病理类型、手术病理分期及组织学分级的变化特点,为更精准的临床诊治提供客观依据。方法回顾性分析1990年1月至2019年12月就诊于首都医科大学附属北京同仁医院及首都医科大学附属北京妇产医院的1721例子宫内膜癌患者的临床资料,以年代为限分为2个阶段(1990~2004年、2005~2019年)进行统计分析,比较两个阶段的发病年龄、病理类型、手术病理分期及组织学分级的变化特点。结果≤40岁病例由9.09%降至5.85%,差异有统计学意义(P=0.011),≥65岁病例由12.12%降至10.69%,差异无统计学意义(P=0.367);Ⅱ型病例由9.57%降至8.50%,差异无统计学意义(P=0.454);晚期(Ⅲ期及Ⅳ期)病例从19.30%升至20.48%,差异无统计学意义(P=0.557);低分化(G3)病例从17.22%升至20.48%,差异无统计学意义(P=0.1)。结论北京市30年来子宫内膜癌的高发年龄没有变化,仍为41~64岁;Ⅰ型子宫内膜癌仍为其主要病理类型,子宫内膜癌手术病理分期未见明显变化,但晚期病例仍占20.05%,低分化病例未见变化。需要重视41~64岁妇女子宫内膜癌的防治,并继续研究早期诊断方法,减少子宫内膜癌特别是晚期病例的发生。

Objective This paper analyzed the Beijing cases of endometrial cancer admitted to two hospitals in Beijing in the past 30 years,and discussed the changes in the age of onset,pathological types,surgical pathological stages and histological grades of endometrial cancer,so as to provide objective basis for more accurate clinical diagnosis and treatment.Methods The clinical data of 1721 patients with endometrial carcinoma treated in Beijing Tongren Hospital and Beijing Obstetrics and Gynecology Hospital from January 1990 to December 2019 were analyzed retrospectively.According to the date,the patients were divided into two groups(1990 to 2004 and 2005 to 2019),the age of onset,pathological type,surgical pathological stage and histological grade of the two groups were compared.Results Patients aged≤40 years old decrease from 9.09% to 5.85%,the difference was statistically significant(P=0.011).Patients aged≥65 years old decreased from 12.12% to 10.69%,the difference was not statistically significant(P=0.367).TypeⅡdecreased from 9.57% to 8.50%,the difference was not statistically significant(P=0.454).Cases of late stage(Ⅲ and Ⅳ)increased from 19.30%to 20.48%,the difference was not statistically significant(P=0.557).Cases of low differentiation(G3)increased from 17.22% to 20.48%,the difference was not statistically significant(P=0.1).Conclusion The age of high incidence of endometrial cancer in Beijing is still 41~64 years old.Type I endometrial carcinoma is still the main pathological type,and the surgical pathological stages of endometrial cancer have not changed significantly,but advanced cases still account for 20.05%.No changes were observed in the patients with low differentiation.Therefore,it is necessary to pay attention to the prevention and treatment of endometrial cancer in women aged 41~64 years old,and continue to study the methods of early diagnosis in order to reduce the incidence of endometrial cancer,especially in advanced cases.