子宫内膜癌合并症146例临床分析

A clinical analysis of 146 cases of endometrial carcinoma with medical disorders

目的 探讨子宫内膜癌合并症的发生情况及其对子宫内膜癌治疗和预后的影响。方法 对 1 971年 7月～ 2 0 0 1年 1 0月在我院住院治疗 ,伴各种合并症的 1 4 6例子宫内膜癌患者 (合并症组 )的临床资料进行回顾性分析 ,并与同期无合并症的 1 61例子宫内膜癌患者 (对照组 )进行比较。结果 子宫内膜癌常见的合并症为高血压病 (1 0 4例 ,71 2 % )、糖尿病 (30例 ,2 0 5 % )、冠心病 (2 9例 ,1 9 9% )等 ;合并症组患者平均年龄 57 8岁 ,对照组患者平均年龄 53 5岁 ,两组比较 ,差异有极显著性(P <0 0 0 1 ) ;而合并症发生情况与肿瘤分期、分化程度和病理类型无关 (P >0 0 5)。合并症组 3例因较重合并症未能手术 ,对照组无因合并症不能手术者 ,而合并症组患者接受放射治疗 (放疗 )、化学药物治疗 (化疗 )的比例 (69 2 % ) ,明显高于对照组 (54 0 % ) ,差异有极显著性 (P <0 0 1 )。对随访的患者进行单因素分析显示 ,是否存在合并症与子宫内膜癌的预后情况无明显相关性 (P >0 0 5)。多因素分析得出 ,肿瘤分期和分化程度对预后有明显影响 ,而年龄及合并症情况对预后无明显影响。结论 子宫内膜癌患者常合并高血压病、糖尿病、冠心病等 ,随年龄增大 ,合并症发生机率增加 。

Objective To report the associate medical disorders of the patients with endometrial carcinoma and analyze the medical disorders' effects on the treatment and prognosis Method One hundred and forty six cases of endometrial carcinoma associated with medical disorders who admitted to our center from July, 1971 to Oct, 2001 were analyzed retrospectively And the other 161 cases without medical disorders who admitted to our center during the same time were chosen as control Results Among the 146 patients with medical disorders, the ordinary disorders were hypertension in 104 patients (71 2%), diabetes mellitus in 30 patients (20 5%) and coronary heart disease in 29 patients (19 9%) Those patients with medical disorders were elder than the control ( P <0 001) The medical disorders were independent of stage,tumor cell differentiation and pathological classification ( P >0 05) The operation ratio of those patients with medical disorders were less than the control But there was no significance ( P >0 05) The radiotherapy and chemotherapy ratio of them was significantly higher than the control ( P <0 01) Univariate analysis of the cases followed up showed that the prognosis were independent of the associated medical disorders, such as hypertension, diabetes mellitus and coronary heart disease ( P >0 05). Multivariate analysis showed that the prognosis were related to the stage and tumor cell differentiation affected the prognosis remarkable But the prognosis was independent of age and associated medical disorders Conclusions The endometrial carcinoma often associates with hypertension, diabetes mellitus, coronary heart disease, and so on The incidence rate of medical disorders increases with the aging of the patients The medical disorders might affect the therapy to a certain extent But they do not affect the prognosis remarkably