【摘要】 目的：探讨晚期子宫内膜癌临床特征及预后相关因素。方法：回顾性分析我院1995.1～2005.1月间收治的39例晚期子宫内膜癌患者临床病理资料和随访结果。结果：①39例患者中，Ⅲ期25例(64.1%)，Ⅳb期14例(35.9%);手术治疗35例，单纯放疗3例，单独孕激素治疗1例;5年生存率21.8%。结论：子宫浆膜受侵、子宫外多处癌灶、宫旁组织受侵犯、宫旁淋巴管或血管有癌栓及淋巴结癌转移仍是影响晚期子宫内膜癌预后的重要因素，Ⅳ期患者易盆腹腔复发和肺转移，预后更差。
【关键词】 子宫内膜癌;治疗;预后;临床分期
Analysis on Treatment and Prognosis for Endometrial Carcinoma in Advanced Stage
KANG Yanhua
The First Affiliated Hospital, Hebei North Universty,Zhangjiakou,075000,Hebei China
【ABSTRACT】 Objective: To investigate the clinical features and prognostic factors of advanced endometrial carcinoma. Methods: Retrospectively laralyze the clinic and pathological features of 39 cases with advanced endometrial carcinoma from 1995 to 2005. Results: Among the 39 cases with endometrial carcinoma 25 cases (64.1%) were in stage Ⅲ, 14 cases (35.9%) were in stage Ⅳ while 35 cases were operated， 3 cases accepted radiotherapy only and one case accepted pregesterone treatment only. The 5year survival rate among them was 21.8%. Conclusion: The involvemens of uterine serous， Tymphonode metastasis， multilesionoutofuterine and lymphovascular invasion (LVI) were most important prognostic factors for stage Ⅲ endometrial carcinoma. The recurrence of pelvic and peritoneal cavity and long distance matestasis was much more in stage Ⅳb.
【KEY WORDS】 Endometrial carcinoma; Treatment; Prognosis;Advanced stage
子宫内膜癌是女性生殖器较常见的恶性肿瘤，近年来，发病率有上升趋势。通过超声、CT、MRI、TCT及诊断性刮宫等方法，可使大多数患者得到早期诊断和及时治疗，但仍有部分患者就诊时即为晚期。对于晚期子宫内膜癌的治疗和预后的报道较少，为了探讨晚期子宫内膜癌临床特征和预后相关因素，本文对我院39例晚期子宫内膜癌患者进行回顾性分析。
1 资料和方法
1.1 一般资料 1995.1～2005.1月我院共收治子宫内膜癌患者132例，其中晚期患者39例，占29.5%，全部病例均经诊刮、TCT及手术病理证实。35例按FIGO手术病理分期标准(1988年)进行分期，4例未手术者按FIGO临床分期标准进行分期。39例患者平均年龄61.9岁(33～77岁)，绝经33例，未绝经6例，7例合并高血压病，4例合并高血压病和糖尿病，4例合并高血压和冠心病。
1.2 治疗
1.2.1 手术治疗 经手术治疗35例，均行次广泛子宫或全子宫及双附件切除术;其中13例同时行盆腔淋巴结切除术;11例行盆腔和腹主动脉旁淋巴结切除术;11例切除了大网膜大部和阑尾。
1.2.2 放射治疗 18例行放射治疗，其中3例因阴道转移(Ⅲb)单纯行放疗;16例术后辅助放疗，放疗包括腔内后装
[1] [2] [3] [4] [5] 下一页
您现在的位置： 绿色健康网 >> 医学论文 >> 妇产科论文 >> 正文