摘要
目的分析子宫内膜浆液性乳头状癌的临床病理特点,探讨其治疗及预后。方法回顾性分析1996年1月—2005年12月在复旦大学附属肿瘤医院手术治疗的33例子宫内膜浆液性乳头状癌患者的临床病理资料。结果33例患者中,手术病理分期Ⅰ期11例,Ⅱ期2例,Ⅲ期7例,Ⅳ期13例。早期患者(Ⅰ期和Ⅱ期)13例,占39%;晚期患者(Ⅲ期和Ⅳ期)20例,占61%。Ⅰ、Ⅲ、Ⅳ期患者的3年总生存率分别为77·4%、53·3%、12·1%,3者间比较,差异有统计学意义(P=0·008)。对手术病理分期、淋巴结受累、肌层浸润深度、病理分级、脉管浸润和p53基因表达情况与预后的关系进行统计学分析,单因素分析发现,仅手术病理分期(P=0·008)和肌层浸润深度(P=0·025)与预后有关;多因素分析发现,仅手术病理分期和病理分级与预后有关(P均<0·05)。晚期患者中,行术后辅助化疗者的生存时间平均为30个月,明显长于未化疗者的6个月(P=0·014)。结论子宫内膜浆液性乳头状癌确诊时多为晚期,预后差。治疗强调全面的手术分期,术后辅助化疗可改善患者的预后。
Objective To analyze the clinico-pathological characteristics, prognostic factors and the rational therapy for the uterine papillary serous carcinoma （UPSC）. Methods Thirty-three cases of UPSC were treated in our hospital between January 1996 and December 2005. The clinico-pathologic characteristics, treatment and prognosis were retrospectively analyzed. Results The three-year overall survival for patients with stage Ⅰ , Ⅲ and Ⅳ was 77.4% ,53.3% and 12. 1%, respectively. Patients with late stages and deep myometrial invasion were associated with a worse prognosis by univariate analysis （ P 〈 0o 05 ）, while in a multivariate analysis only late stages and poor differentiation were associated with a poor prognosis（P 〈0. 05）. The prognosis of patients in late stages treated with postoperative chemotherapy was significantly better than those without chemotherapy（ P =0. 014）. Conclusions Most UPSC patients are in late stages at diagnosis. They often have extra-uterine metastasis and have a poor prognosis. Complete surgical staging is recommended, and postoperative chemotherapy seems to improve the prognosis.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2006年第12期817-821,共5页
Chinese Journal of Obstetrics and Gynecology
关键词
子宫内膜肿瘤
癌
乳头状
肿瘤分期
预后
Endometrial neoplasms
Carcinoma,papillary
Neoplasm staging
Prognosis
