Clinical Analysis of Uterine Papillary Serous Carcinoma and Uterine Clear Cell Carcinoma
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摘要:
目的 分析子宫内膜乳头状浆液性腺癌(UPSC)与透明细胞癌(UCCC)的临床特点及预后。 方法 回顾性分析天津市中心妇产科医院2004年4月至2012年7月收治的41例UPSC与19例UCCC临床资料。 结果 UPSC完全手术分期24例, 早期(仅Ⅰ期)9例, 晚期(Ⅲ、Ⅳ期)15例。UCCC完全手术分期10例, 早期(仅Ⅰ期)6例, 晚期(Ⅲ、Ⅳ期)4例。单因素分析显示: 脉管浸润、腹水/腹腔冲洗液细胞学阳性及淋巴结转移者总生存期(OS)较短; 脉管浸润、肌层浸润、腹水/腹腔冲洗液细胞学阳性者无病生存期(DFS)较短。多因素Cox回归分析显示: 淋巴结转移、腹水/腹腔冲洗液细胞学阳性者的患者OS较短; 脉管浸润、腹水/腹腔冲洗液细胞学阳性者的患者DFS较短。 结论 UPSC确诊时多为晚期, 预后差。治疗强调全面手术分期, 脉管浸润、肌层浸润、腹水/腹腔冲洗液及淋巴结转移与预后相关。 -
关键词:
- 子宫内膜乳头状浆液性腺癌 /
- 透明细胞癌 /
- 治疗 /
- 预后分析
Abstract:Objective This study was designed to analyze the clinico-pathological features and prognostic factors of uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC). Methods A retrospective analysis of 41 UPSC patients and 19 UCCC patients who were treated in Tianjin Central Hospital of Gynecology Obstetrics between April 2004 and July 2012 was performed. Results Among the UPSC patients, 24 were subjected to comprehensive surgical staging, which revealed that 9 (37.5%) and 15 (62.5%) patients exhibited early- (only I) and advanced-stage (II1/IV) carcinoma, respectively. For the UCCC patients, 10 were subjected to comprehensive surgical staging, which showed that 6 (60%) and 4 (40%) patients manifested early- (only I) and advanced-stage (IU/IV) carcinoma, re- spectively. Univariate analysis results showed that vascular invasion, positive ascites/peritoneal washing cytology, and lymph node metastasis were the important prognostic factors for overall survival (OS). For disease-free survival (DFS), vascular invasion, myometrial invasion, and positive ascites/peritoneal washing cytology were the important prognostic factors. Multivariate analysis results revealed that vascular invasion and positive ascites/peritoneal washing cytology were the important prognostic factors for OS, whereas positive ascites/peritoneal washing cytology and lymph node metastasis were the important prognostic factors for DFS. Conclusions Poor prognosis of patients was observed when most of them were initially diagnosed with UPSC, particularly when the diagnosis revealed advanced-stage carcinoma. Thus, comprehensive surgical staging is recommended. Furthermore, vascular invasion, myometrial invasion, and lymph node metastasis as well as the result of ascites/peritoneal washings should be considered during prognosis. -
图 2 腹水/腹腔冲洗液细胞学阳性患者生存曲线
Figure 2. Overall survival curves in patients with positive ascites/peritoneal washing cytology
图 3 脉管浸润患者DFS
Figure 3. Disease-free survival curves in patients with vascular invasion
图 4 腹水/腹腔冲洗液细胞学阳性患者DFS
Figure 4. Disease-free survival curves in patients with positive ascites/peritoneal washing cytology
表 1 手术病理分期 例
Table 1. Pathological staging during surgery
表 2 术后病理结果 例
Table 2. Pathological results after surgery
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