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本文对自1958～1981年底中国医学科学院肿瘤医院治疗的418例宫内膜患者进行回顾性研究。其中Ⅰ期228例,Ⅱ期105例、Ⅲ期76例,Ⅳ期9例,复发共75例。在Ⅰ、Ⅱ期患者,影响预后的因素有:(1)宫颈管受累,(2)肌层侵犯,(3)治疗方式。手术或手术与放射综合治疗是最宜的治疗方式。Ⅱ期颈管受累的假阳性率较高(56.1％),因而靠分段诊刮取材而做出诊断的弊端有待解决。对Ⅲ、Ⅳ期患者如有可能也应尽量切除原发病灶,不能手术者放射治疗是主要治疗手段,并应辅以激素或化疗。复发患者虽预后不佳但不应轻易放弃治疗。作者在总结我院418例患者治疗和预后的基础上结合已开展的雌、孕激素受体测定,重新整理和制定了包括手术、放射、激素和化疗在内的宫内膜癌的综合治疗方案。
This article retrospectively studied 418 endometrial patients treated by the Chinese Academy of Medical Sciences Cancer Hospital from the end of 1958 to the end of 1981. There were 228 cases of stage Ⅰ, 105 cases of stage Ⅱ, 76 cases of stage Ⅲ, 9 cases of stage Ⅳ, and 75 cases of recurrence. In stage I, II patients, prognostic factors include: (1) cervical canal involvement, (2) myometrial invasion, (3) treatment. Surgery or surgery combined with radiation therapy is the most appropriate treatment. The false positive rate of neck canal involvement in stage Ⅱ was higher (56.1%), so the drawbacks of making diagnosis by sectional curettage have yet to be solved. On Ⅲ, Ⅳ patients, if possible, should also be the primary resection of the lesion, who can not operate radiotherapy is the main treatment, and should be supplemented with hormones or chemotherapy. Although the prognosis of patients with poor prognosis should not give up treatment. On the basis of summarizing the treatment and prognosis of 418 patients in our hospital, the authors combined the tests of estrogen and progesterone receptor that have been carried out to rearrange and formulate a comprehensive treatment plan for endometrial cancer including surgery, radiation, hormones and chemotherapy .