摘要
目的探讨单纯腹水细胞学检查阳性对早期子宫内膜癌预后的影响及术后辅助治疗的意义。方法对2000年1月~2010年12月期间64家广东省子宫内膜癌防治项目协作医院收集的3 415例Ⅰ~Ⅱ期子宫内膜癌患者临床资料进行回顾性分析,按有无高危因素分为低危组（n=2 026）和高危组（n=1 389）。比较两组腹水细胞学检查阳性与阴性患者预后及术后辅助治疗对阳性患者预后的影响。结果 ①低危组中腹水细胞学检查阳性和阴性患者的5年总体生存率分别为97.3%和98.3%,5年无进展生存率分别为92.2%和96.2%,差异均无统计学意义（P〉0.05）;高危组中腹水细胞学检查阳性和阴性患者的5年总体生存率分别为85.7%和91.3%,5年无进展生存率分别为76.2%和86.4%,差异有统计学意义（P〈0.05）。②单纯腹水细胞学检查阳性中,低危组行术后辅助治疗和未行术后辅助治疗的5年总体生存率分别为91.7%和95.2%,5年无进展生存率分别为92.3%和92.8%,差异均无统计学意义（P〉0.05）;高危组行术后辅助治疗和未行术后辅助治疗的5年总体生存率分别为84.4%和88.5%,5年无进展生存率分别为71.0%和85.2%,差异均无统计学意义（P〉0.05）。结论对于早期子宫内膜癌,无合并高危因素的单纯腹水细胞学检查阳性并不影响患者的预后,若合并其他高危因素提示预后不良,术中常规进行腹水细胞学检查仍是十分必要的。术后辅助治疗对改善无宫外转移的单纯腹水细胞学检查阳性患者的预后意义不大。
Objective To evaluate prognostic effect of positive peritoneal cytology in early stage endometrial cancer and significance of adjuvant therapy. Methods The clinical data of 3 415 patients with stageⅠtoⅡendometrial cancer from January 2000 to December 2010 in 64 hospitals of endometrial cancer prevention projects in Guangdong Province were analyzed retrospectively. All patients were divided into low-risk group（ n = 2 026）and high-risk group（ n = 1 389）. The prognostic effect were compared between positive and negative peritoneal cytology patients in two groups,and the prognostic effect of positive peritoneal cytology were compared between performed and un-performed adjuvant therapy patients in two groups. Results ① 5-year overall survival rate of positive and negative peritoneal cytology patients in low-risk group were 97. 3% and 98. 3% respectively,and5-year progression-free survival rate were 92. 2% and 96. 2% respectively,the prognosis between positive and negative peritoneal cytology patients were no statistically difference（ P〉0. 05）. 5-year overall survival rate of positive and negative peritoneal cytology patients in high-risk group were 85. 7% and 91. 3% respectively,and 5-year progression-free survival rate were 76. 2% and 86. 4% respective,the prognosis between positive and negative peritoneal cytology patients were statistically significance（ P〈0. 05）. ② 5-year overall survival rate of the patients performed and non-performed adjuvant treatment in low-risk group with positive peritoneal cytology was 91. 7% and 95. 2%,and 5-year progression-free survival rate was 92. 3% and 92. 8%,the prognosis between them were no statistically difference（ P〉0. 05）. 5-year overall survival rate of the patients performed and non-performed adjuvant treatment in high-risk group with positive peritoneal cytology was 84. 4% and 88. 5%,and 5-year progression-free survival rate was 71. 0% and 85. 2%,the prognosis between them were no statistically difference（ P〉0. 05）. Conclusions For early stage endometrial cancer patients,positive peritoneal cytology without high risk factors did not affect their prognosis,while positive peritoneal cytology with high risk factors revealed bad prognosis. So it was necessary to perform peritoneal cytological examination during surgery. Adjuvant treatment seemed to have no effect on prognosis of positive peritoneal cytology in endometrial cancer confined to the uterus.
出处
《中国现代手术学杂志》
2015年第3期161-166,共6页
Chinese Journal of Modern Operative Surgery
基金
国家自然科学基金(编号:30772332)
广东省自然学科基金(编号:S2012010008640)
广东省妇幼安康工程-子宫内膜癌防治项目
关键词
子宫内膜肿瘤
腹水细胞学
预后
endometrial neoplasms
peritoneal cytology
prognosis
