论文部分内容阅读
目的探讨绝经前子宫内膜癌患者的适宜治疗方法。方法选取2010年1月-2012年1月医院收治的绝经前子宫内膜癌患者28例(同期子宫内膜癌患者总计158例)。收集患者的临床、病理、免疫组化资料;回顾性分析、比较不同年龄段绝经前子宫内膜癌患者的临床病理资料情况;分析绝经前子宫内膜癌患者病理、免疫组化、治疗方法与预后的关系。结果 23例以手术为主综合治疗患者中,其中2例分别在术后24个月和36个月复发,部位均在阴道局部。5例未手术,其中单纯醋酸甲羟孕酮(MPA)治疗3例,分别随访24、30及54个月无复发,且1例妊娠并生育。绝经前子宫内膜癌病理类型为鳞癌、腺癌伴鳞状上皮分化的复发率高于腺癌,病理分期为Ⅲ、Ⅳ期的患者复发率高于Ⅰ、Ⅱ期,差异均有统计学意义(P<0.05)。结论绝经前子宫内膜癌病理类型、病理分期与子宫内膜癌预后存在相关。对于绝经前子宫内膜癌患者,根据个体情况选择合适手术方式和辅助治疗;尤其对于尚未生育女性,根据其病理资料和免疫组化指标,优先考虑内分泌治疗。
Objective To investigate the suitable treatment of premenopausal women with endometrial cancer. Methods Twenty-eight patients with premenopausal endometrial cancer (158 patients with endometrial cancer in the same period) were selected from January 2010 to January 2012 in our hospital. The clinical, pathological and immunohistochemical data were collected. The clinical and pathological data of patients with endometrial cancer in different age groups were compared and analyzed. The pathological, immunohistochemical and therapeutic methods of premenopausal endometrial carcinoma Prognosis of the relationship. Results Of the 23 patients who underwent primary surgery, 2 of them were recurrent at 24 months and 36 months respectively. The sites were all located in the vagina. Among the 5 cases who did not have surgery, 3 cases were treated with melatonin acetate alone (MPA). No recurrence was observed after 24, 30 and 54 months of follow - up, and 1 case of pregnancy and fertility. The pathological type of premenopausal endometrial carcinoma was squamous cell carcinoma, the recurrence rate of adenocarcinoma with squamous epithelium was higher than that of adenocarcinoma, the recurrence rate was higher in stage Ⅲ and Ⅳ patients than in stage Ⅰ and Ⅱ, the difference was statistically Significance (P <0.05). Conclusion The pathological type, pathological stage of premenopausal endometrial carcinoma are related to the prognosis of endometrial carcinoma. For patients with premenopausal endometrial cancer, according to individual circumstances, select the appropriate surgical methods and adjuvant therapy; especially for women who have not yet been born, according to their pathological data and immunohistochemical indicators, giving priority to endocrine therapy.