499例子宮內膜癌預后及隨訪資料分析_《華西醫學》

作者：

吳秀麗 , 何英 , 楊開選

四川大學華西第二醫院病理科，四川成都 610041;

關鍵詞：

子宮內膜癌隨訪預后

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的:總結分析子宮內膜癌臨床特點、治療方法的療效及與各預后高危因素之間的關系，以提高臨床診療水平。方法:回顧性分析我院1998年1月～2005年12月收治住院的子宮內膜癌患者499例的臨床病理資料，總結患者的一般情況、臨床特點并進行隨訪，分析內膜癌高危因素對預后的影響。采用壽命表法計算患者生存率，Wilcoxon (Gehan) 比分法及Cox比例風險模型分析預后因素。結果:(1) 手術－病理分期I、Ⅱ、Ⅲ期患者5年生存率分別為94%、100％、75.3％，IV期患者1年生存率57.1%、2年生存率11.4％。(2) 單因素分析顯示：病理類型、手術－病理分期、組織學分級、肌層浸潤深度、淋巴結轉移和是否行淋巴結切除術是影響預后的高危因素。（3）多因素分析顯示：病理類型、手術－病理分期、組織學分級和肌層浸潤深度是影響患者預后的獨立危險因素。結論:(1) 對具有高危因素的患者，如特殊病理類型、手術－病理分期期別晚、組織學分級為G3和深肌層浸潤，應輔以術后治療以提高生存率。(2)分期越晚，生存率越低（P lt;0.05）。

引用本文： 吳秀麗,何英,楊開選. 499例子宮內膜癌預后及隨訪資料分析. 華西醫學, 2009, 24(6): 1403-1407. doi: 復制

1.	曹澤毅主編. 中華婦產科學[M].北京: 人民衛生出版社, 第一版.1999: 1844-1845..
2.	FIGO ( International Federation of Gynecology and Obstetrics ) annual report on the results of treatment in gynecological cancer[J]. Int J Gynaecol Obstet, 2003, 83 Suppl 1: ixxxii, 1-229..
3.	JAIME PART. Prognostic parameters of endometrial carcinoma[J]. Human pathology,2004, 35 (6) : 649-662..
4.	彭芝蘭, 劉興會, 張家文,等. 子宮內膜癌290例臨床分析與手術病理分期的比較[J]. 中華婦產科雜志,1997, 32（10）: 597-600..
5.	ELTABBAKH G, MOORE A. Survival of women surgical stage Ⅱ endometrial cancer[J]. Gynecol Oncol, 1999, 74: 80-85..
6.	BORONOW RC. Surgical staging of endometrial cancer: Evolution, evaluation, and responsible challenge. A personal perspective[J]. Gynecol Oncol, 1997, 66: 179-189..
7.	CREASMAN WT, DISAIA PJ, BLESSING J, et al. Prognostic significance of peritoneal cytology in patients with endometrial cancer and preliminary data concerning therapy with intraperitoneal radioparmaceuticals[J]. Am J Obstet Gynecol, 1981,141:921-929..
8.	LURAIN JR, RUMSEY NK, SCHINK JC, et al. Prognostic significance of positive peritoneal cytology in clinical stage I adenocarcinoma of endometrium[J]. Obstet Gynecol, 1989,74:175179..
9.	KADAR N, HOMESLEY HD, MALFETANO JH. Positive peritoneal cytology is an adverse factor in endometrial carcinoma only if there is other evidence of extrauterine disease[J]. Gynecol Onkol, 1992,46:145-149.
10.	KILGORE LC, PARTRIDGE EE, ALVAREZ RD, et al. Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling[J]. Gynecol Onkol, 1995, 56:29-33..
11.	MOHAN DS, SAMUEL MA, SELIM MA, et al. Longterm outcomes of therapeutic pelvic lymphadenectomy for stage I adenocarcinoma[J]. Gynecol Onkol, 1998, 70: 165-171..
12.	ALESSANDRO D SANTIN , STEFANIA BELLONE , TIMOTHY J O’BRIEN, et al. Current treatment options for endometrial cancer. Expert Rev[J]. Anticancer Ther, 2004,4 (4) :679689..
13.	曹澤毅. 婦科惡性腫瘤治療中對淋巴處理的商榷[J]. 中華婦產科學,2004, 39（2）: 135-147..

1. 曹澤毅主編. 中華婦產科學[M].北京: 人民衛生出版社, 第一版.1999: 1844-1845..
2. FIGO ( International Federation of Gynecology and Obstetrics ) annual report on the results of treatment in gynecological cancer[J]. Int J Gynaecol Obstet, 2003, 83 Suppl 1: ixxxii, 1-229..
3. JAIME PART. Prognostic parameters of endometrial carcinoma[J]. Human pathology,2004, 35 (6) : 649-662..
4. 彭芝蘭, 劉興會, 張家文,等. 子宮內膜癌290例臨床分析與手術病理分期的比較[J]. 中華婦產科雜志,1997, 32（10）: 597-600..
5. ELTABBAKH G, MOORE A. Survival of women surgical stage Ⅱ endometrial cancer[J]. Gynecol Oncol, 1999, 74: 80-85..
6. BORONOW RC. Surgical staging of endometrial cancer: Evolution, evaluation, and responsible challenge. A personal perspective[J]. Gynecol Oncol, 1997, 66: 179-189..
7. CREASMAN WT, DISAIA PJ, BLESSING J, et al. Prognostic significance of peritoneal cytology in patients with endometrial cancer and preliminary data concerning therapy with intraperitoneal radioparmaceuticals[J]. Am J Obstet Gynecol, 1981,141:921-929..
8. LURAIN JR, RUMSEY NK, SCHINK JC, et al. Prognostic significance of positive peritoneal cytology in clinical stage I adenocarcinoma of endometrium[J]. Obstet Gynecol, 1989,74:175179..
9. KADAR N, HOMESLEY HD, MALFETANO JH. Positive peritoneal cytology is an adverse factor in endometrial carcinoma only if there is other evidence of extrauterine disease[J]. Gynecol Onkol, 1992,46:145-149.
10. KILGORE LC, PARTRIDGE EE, ALVAREZ RD, et al. Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling[J]. Gynecol Onkol, 1995, 56:29-33..
11. MOHAN DS, SAMUEL MA, SELIM MA, et al. Longterm outcomes of therapeutic pelvic lymphadenectomy for stage I adenocarcinoma[J]. Gynecol Onkol, 1998, 70: 165-171..
12. ALESSANDRO D SANTIN , STEFANIA BELLONE , TIMOTHY J O’BRIEN, et al. Current treatment options for endometrial cancer. Expert Rev[J]. Anticancer Ther, 2004,4 (4) :679689..
13. 曹澤毅. 婦科惡性腫瘤治療中對淋巴處理的商榷[J]. 中華婦產科學,2004, 39（2）: 135-147..

《華西醫學》

499例子宮內膜癌預后及隨訪資料分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《華西醫學》

499例子宮內膜癌預后及隨訪資料分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料