目的:總結(jié)分析子宮內(nèi)膜癌臨床特點(diǎn)、治療方法的療效及與各預(yù)后高危因素之間的關(guān)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(nèi)膜癌患者499例的臨床病理資料,總結(jié)患者的一般情況、臨床特點(diǎn)并進(jìn)行隨訪,分析內(nèi)膜癌高危因素對(duì)預(yù)后的影響。采用壽命表法計(jì)算患者生存率,Wilcoxon (Gehan) 比分法及Cox比例風(fēng)險(xiǎn)模型分析預(yù)后因素。結(jié)果:(1) 手術(shù)-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(lèi)型、手術(shù)-病理分期、組織學(xué)分級(jí)、肌層浸潤(rùn)深度、淋巴結(jié)轉(zhuǎn)移和是否行淋巴結(jié)切除術(shù)是影響預(yù)后的高危因素。(3)多因素分析顯示:病理類(lèi)型、手術(shù)-病理分期、組織學(xué)分級(jí)和肌層浸潤(rùn)深度是影響患者預(yù)后的獨(dú)立危險(xiǎn)因素。結(jié)論:(1) 對(duì)具有高危因素的患者,如特殊病理類(lèi)型、手術(shù)-病理分期期別晚、組織學(xué)分級(jí)為G3和深肌層浸潤(rùn),應(yīng)輔以術(shù)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(kāi)選. 499例子宮內(nèi)膜癌預(yù)后及隨訪資料分析. 華西醫(yī)學(xué), 2009, 24(6): 1403-1407. doi: 復(fù)制
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1. | 曹澤毅主編. 中華婦產(chǎn)科學(xué)[M].北京: 人民衛(wèi)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: ixxxii, 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(huì), 張家文,等. 子宮內(nèi)膜癌290例臨床分析與手術(shù)病理分期的比較[J]. 中華婦產(chǎn)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, 1989,74:175179.. |
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. Longterm 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) :679689.. |
13. | 曹澤毅. 婦科惡性腫瘤治療中對(duì)淋巴處理的商榷[J]. 中華婦產(chǎn)科學(xué),2004, 39(2): 135-147.. |
- 1. 曹澤毅主編. 中華婦產(chǎn)科學(xué)[M].北京: 人民衛(wèi)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: ixxxii, 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(huì), 張家文,等. 子宮內(nèi)膜癌290例臨床分析與手術(shù)病理分期的比較[J]. 中華婦產(chǎn)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, 1989,74:175179..
- 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. Longterm 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) :679689..
- 13. 曹澤毅. 婦科惡性腫瘤治療中對(duì)淋巴處理的商榷[J]. 中華婦產(chǎn)科學(xué),2004, 39(2): 135-147..