摘要
目的:分析子宫内膜乳头状浆液性腺癌(UPSC)与透明细胞癌(UCCC)的临床特点及预后。方法:回顾性分析天津市中心妇产科医院2004年4月至2012年7月收治的41例UPSC与19例UCCC临床资料。结果:UPSC完全手术分期24例,早期(仅Ⅰ期)9例,晚期(Ⅲ、Ⅳ期)15例。UCCC完全手术分期10例,早期(仅Ⅰ期)6例,晚期(Ⅲ、Ⅳ期)4例。单因素分析显示:脉管浸润、腹水/腹腔冲洗液细胞学阳性及淋巴结转移者总生存期(OS)较短;脉管浸润、肌层浸润、腹水/腹腔冲洗液细胞学阳性者无病生存期(DFS)较短。多因素Cox回归分析显示:淋巴结转移、腹水/腹腔冲洗液细胞学阳性者的患者OS较短;脉管浸润、腹水/腹腔冲洗液细胞学阳性者的患者DFS较短。结论:UPSC确诊时多为晚期,预后差。治疗强调全面手术分期,脉管浸润、肌层浸润、腹水/腹腔冲洗液及淋巴结转移与预后相关。
Objective： This study was designed to analyze the clinico-pathological features and prognostic factors of uterine papillary serous carcinoma （UPSC） and uterine clear cell carcinoma （UCCC）. Methods： A retrospective analysis of 41 UPSC patients and 19 UCCC patients who were treated in Tianjin Central Hospital of Gynecology Obstetrics between April 2004 and July 2012 was performed. Results： Among the UPSC patients, 24 were subjected to comprehensive surgical staging, which revealed that 9 （37.5%） and 15 （62.5%） patients exhibited early- （only I ） and advanced-stage （II1/IV） carcinoma, respectively. For the UCCC patients, 10 were subjected to comprehensive surgical staging, which showed that 6 （60%） and 4 （40%） patients manifested early- （only I ） and advanced-stage （IU/IV） carcinoma, re- spectively. Univariate analysis results showed that vascular invasion, positive ascites/peritoneal washing cytology, and lymph node metastasis were the important prognostic factors for overall survival （OS）. For disease-free survival （DFS）, vascular invasion, myometrial invasion, and positive ascites/peritoneal washing cytology were the important prognostic factors. Multivariate analysis results revealed that vascular invasion and positive ascites/peritoneal washing cytology were the important prognostic factors for OS, whereas positive ascites/peritoneal washing cytology and lymph node metastasis were the important prognostic factors for DFS. Conclusions： Poor prognosis of patients was observed when most of them were initially diagnosed with UPSC, particularly when the diagnosis revealed advanced-stage carcinoma. Thus, comprehensive surgical staging is recommended. Furthermore, vascular invasion, myometrial invasion, and lymph node metastasis as well as the result of ascites/peritoneal washings should be considered during prognosis.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2012年第23期1912-1915,共4页
Chinese Journal of Clinical Oncology
关键词
子宫内膜乳头状浆液性腺癌
透明细胞癌
治疗
预后分析
Uterine papillary serous carcinoma
Uterine clear cell carcinoma
Treatment
Prognostic analysis
