性激素表达对子宫内膜癌患者预后影响研究

目的:探讨子宫内膜癌患者血清雌激素水平与其预后的关系.方法:回顾性分析我科自2005年1月至2008年6月期间收治的95例绝经后子宫内膜癌患者的临床资料,所有患者均行手术治疗,术前采取清晨空腹外周静脉血,采用标准放射免疫测定法进行血清雌二醇测定.根据患者雌二醇水平将95例患者分为两组,45例患者血浆雌二醇≥385pmol/L为 A组,50例患者血浆雌二醇<385pmol/L为 B组.对两组患者临床表现、伴发疾病、临床分期、肌层浸润及病理分型等进行比较,并随访患者3年,观察比较两组患者3年生存率.结果:A组患者肥胖、糖尿病及高血压等疾病发生率明显高于 B组患者,差异均有统计学意义(P<0.05).A组患者绝经后阴道流血及子宫肌瘤发生率也高于 B组,但差异不显著.A组患者临床分期以Ⅱ期和Ⅲ期为主,B组患者以 I期和Ⅱ期为主,A组患者深层浸润率明显高于 B组患者,两组差异具有统计学意义(P<0.05).A组患者腺鳞癌占比明显高于 B组患者,腺癌占比明显低于 B组患者,两组差异具有统计学意义(P<0.05).A组患者3年生存率为77.78%,B组患者为94.00%,前者显著低于后者,差异有统计学意义(P<0.05).结论:绝经后子宫内膜癌患者休内雌激素雌二醇的表达越高,其预后愈差,可通过测定患者血清雌激素水平,预测预后及指导临床治疗.

Effect of sex hormone expression on the prognosis of patients with endometrial carcinoma

Objectives: to explore the relationship between serum estrogen levels and the prognosis of patients with endometrial carcinoma.Methods: A retrospective analysis was made on the clinical data of 95 patients who were diagnosed with postmenopausal endometrial carcinoma and were admitted into our hospital from January 2005 to June 2008.All patients received surgical treatment.Prior to the operation,peripheral venous blood was sampled early in the morning to test the serum estradiol level with standard radioimmunoassay.Based on estradiol levels,the patients were divided into two groups: 45 patients with plasma estradiol ≥ 385pmol / L for group A,50 cases of patients with plasma estradiol <385pmol / L for group B.The two groups were compared in their clinical manifestations,complications,clinical stage,myometrial invasion,pathological type and 3-year survival rates.Results: Group A patients showed a significantly higher rate in the occurrence of obesity,diabetes and hypertension than group B patients(P<0.05).Group A patients also revealed a higher rate of incidence of postmenopausal vaginal bleeding and uterine fibroids than group B,but the difference was not significant.The deep infiltration rate of Group A patients was significantly higher than group B patients(P<0.05).Group A patients also showed a significantly higher occurrence of adenosquamous carcinoma,but significantly lower adenocarcinoma occurrence than group B patients(P<0.05).In group A,The 3-year survival rate was 77.78% as compare with the rate of 94.00% in Group B(P<0.05).Conclusion: The high level of serum estrogen expression is associated with the poor prognosis of endometrial carcinoma patients.The test of serum estrogen levels can help to predict the prognosis and guide the clinical treatment.