cyclinD1、p16蛋白在子宫内膜癌中的表达及其临床意义

目的 :探讨cyclinD1、p16与子宫内膜癌发生与发展的关系。方法 :用免疫组化SP法检测了 50例子宫内膜癌、2 2例子宫内膜不典型增生、10例正常子宫内膜组织中cyclinD1、p16蛋白的表达情况。结果 :cyclinD1蛋白在正常子宫内膜、内膜不典型增生、子宫内膜癌中的表达率分别为 0 ( 0 /10 )、2 2 .73% ( 5/2 2 )、4 0 .0 0 % ( 2 0 /50 ) ,其中子宫内膜癌与正常内膜差异有显著性 (P <0 .0 5)。p16蛋白在内膜癌的表达率为 4 6.0 0 % ,明显低于正常内膜组织的 90 .0 0 % (P <0 .0 5)。 50例内膜癌中 ,cyclinD1蛋白在G2 、G3级及临床Ⅱ～Ⅲ期中的表达率分别高于G1级及临床Ⅰ期 (P <0 .0 5) ,复发组表达率高于未复发组 (P <0 .0 5)。p16蛋白表达与子宫内膜癌的细胞分级、临床分期及预后有关 (P <0 .0 5) ,p16蛋白表达阴性者分化差 ,分期晚 ,复发率高。相关性分析显示 ,cyclinD1与p16表达呈负相关 ,二者协同异常表达者生物学行为较差。结论 :cyclinD1、p16与子宫内膜癌的发生、发展密切相关 ,二者异常表达提示子宫内膜癌复发率高、预后差     

子宫内膜癌组织中FHIT、MMP-2的表达与临床病理的相关性研究

目的:探讨脆性组氨酸三联体(FHIT)和基质金属蛋白酶 2 (MMP- 2 )在子宫内膜癌组织中的表达及其与临床病理特征的关系。方法:免疫组化S P法检测12例正常子宫内膜,4 2例子宫内膜癌组织中FHIT、MMP- 2表达情况。结果:FHIT、MMP -2在正常子宫内膜和子宫内膜癌组织中的阳性表达率分别为10. 0 %、5 9.5 % ;4 1.7%、90 .5 % ,差异具有显著性(P =0 .0 11、P =0 .0 0 1)。在子宫内膜癌组织中,FHIT、MMP 2表达与子宫内膜癌的临床病理参数关系密切,表达强度与组织学病理分级、手术分期、肌层浸润程度和淋巴结转移相关(P <0 .0 1) ,FHIT、MMP -2表达存在负相关性(r=- 0 .6 5 7,P =0 .0 0 0 )。结论:联合检测FHIT、MMP 2在子宫内膜癌组织中的表达可为子宫内膜癌的早期诊断,进一步治疗及预后判断提供必要的理论依据。     

基质金属蛋白酶及其组织抑制因子在子宫内膜癌中的表达及其意义

目的　研究基质金属蛋白酶 (matrixmetalloproteinases,MMPs) 2、9及其组织抑制因子(tissueinhibitorofmetalloproteinases ,TIMPs) 1、2在子宫内膜癌中的表达 ,探讨其与子宫内膜癌浸润转移的关系。方法　应用链霉菌抗生物素蛋白 过氧化物酶免疫组织化学方法和明胶酶谱法对 37例内膜癌及 7例绝经期妇女子宫内膜组织中MMP 2、MMP 9、TIMP 1、TIMP 2蛋白及其活性进行检测。结果　MMP 2、MMP 9及TIMP 1、TIMP 2蛋白主要分布在内膜癌细胞、血管内皮细胞及绝经期子宫内膜腺上皮细胞中 ,在间质细胞中也有少量表达。内膜癌细胞中 ,MMP 2、MMP 9及TIMP 1蛋白的表达 ,病理分级为G3内膜癌的强阳性率分别为 73%、2 0 %及 6 7% ,高于G2 (13%、0及 2 7% )、G1 者 (均为 0 ,P<0 0 5 ) ;深肌层浸润内膜癌的强阳性率分别为 6 3%、16 %及 6 8% ,高于浅肌层浸润的 8%、0及 0 (P<0 0 1) ;有淋巴结转移者的强阳性率分别为 4例中 4例、4例中 3例及 4例中 4例 ,高于无淋巴结转移者的 2 5 %、0及 2 5 % (P <0 0 5 ) ;手术病理分期为Ⅲ～Ⅳ期者强阳性率分别为 5例中 5例、5例中 3例及 5例中 5例 ,高于Ⅰ～Ⅱ期者的 30 %、0及 30 % (P <0 0 5 ) ;TIMP 2蛋白在不同病理分级、肌层浸润、淋巴结转移和手术病理分期的内膜癌细     

子宫内膜癌中nm23和c-erbB-2蛋白的表达及其意义

目的　研究nm2 3和c -erbB - 2蛋白在子宫内膜癌中的表达及其临床意义。方法　用LSAB免疫组化法检测 4 2例子宫内膜癌中nm2 3和c -erbB - 2蛋白的表达。结果　nm2 3和c -erbB - 2在子宫内膜癌中的阳性表达率分别为 6 0 0 %、 4 7 6 % ,其阳性表达与年龄、不同组织学类型差异无显著 (P >0 0 5 ) ;nm2 3与病理分级呈负相关 (P <0 0 1 ) ,无淋巴结转移者阳性表达率明显高于淋巴结转移者 (71 9%和 2 0 0 % ,P <0 0 5 ) ;c -erbB - 2的表达与癌细胞的分化程度、临床分期有关 ,分化程度高及早期癌中c -erbB - 2表达强。结论　对子宫内膜癌组织进行nm2 3和c -erbB - 2蛋白的检测 ,有助于了解子宫内膜癌的临床病理特征和预后     

子宫内膜癌肌层浸润深度的评估

目的　探讨术前B超、术中肉眼观察、术后大体标本测量和血清CA12 5测定 ,对判断子宫内膜癌肌层浸润深度的价值。方法　采用术前B超、术中肉眼观察和术后大体标本测量对 13 3例手术病理分期Ⅰ期子宫内膜癌患者的肌层浸润深度的判断进行评估 ,并分析 91例 (79例为Ⅰ期 ,12例为同期的Ⅱ～Ⅳ期患者 )子宫内膜癌患者血清CA12 5水平与子宫内膜癌的关系。结果　术前B超判断子宫内膜癌肌层浸润和深肌层浸润的敏感性分别为 62 6%和 47 8% ,特异性分别为 67 7%和90 0 % ;术中肉眼观察判断子宫内膜癌肌层浸润和深肌层浸润的敏感性分别为 5 9 6%和 73 9% ,特异性分别为 76 5 %和 94 6% ;术后大体标本测量判断子宫内膜癌肌层浸润和深肌层浸润的敏感性分别为 70 0 %和 94 4% ,特异性分别 92 0 %和 97 7%。子宫内膜癌手术病理分期Ⅰ期患者血清CA12 5水平异常 (≥ 3 5kU/L)的发生率为 8% (6/79) ,Ⅱ～Ⅳ期患者的发生率为 5 8% (7/12 ) ,血清CA12 5水平异常的发生率与手术病理分期的期别有极显著相关性 (P <0 0 0 1) ,而与子宫内膜癌肌层浸润深度无显著相关性 (P >0 0 5 )。结论　术前B超、术中肉眼观察和术后大体标本测量对判断Ⅰ期子宫内膜癌肌层浸润深度有一定帮助 ,其中术后大体标本测量的准确性相对较好。血     

子宫内膜癌1299例临床病理分析

目的分析子宫内膜癌临床病理特点及变化趋势,探讨子宫内膜癌诊治中的相关问题。方法回顾性分析1989年1月至2007年6月经四川大学华西第二医院手术治疗的1299例子宫内膜癌患者的临床病理资料,并分3时段进行对比分析(第1时段:1989-1995年,290例;第2时段:1996-2003年,499例;第3时段:2004-2007年6月,510例)。结果(1)我院3时段年均收治手术治疗子宫内膜癌患者分别为41、62、146例,呈逐年显著上升趋势。(2)3时段<45岁患者所占比例分别为5.5%、14.4%及18.6%,呈上升趋势(P<0.05)。(3)特殊病理类型(非子宫内膜样腺癌)所占比例第3时段上升至13.5%,高于第1时段的0.3%和第2时段的7.6%(P<0.05)。(4)每个时段内临床分期误差率以Ⅱ期为最高,3时段分别为80.5%、67.5%及77.8%。结论(1)子宫内膜癌发病逐年增多,且发病年龄有年轻化趋势。(2)特殊病理类型子宫内膜癌所占比例显著增加。(3)子宫内膜癌临床Ⅱ期分期误差率仍较高。     

老年妇科肿瘤132例分析

本文根据我院的临床病例资料 ,就老年妇女 (>6 0岁 )妇科肿瘤的临床特点、围手术期处理及并发症防治作一分析。1　临床资料1 1　一般资料　 1984年 1月至 1998年 12月间 ,我院共收治各类妇科肿瘤 1995例。其中老年患者 132例 ,占同期妇科肿瘤患者的 6 6 %。其中恶性肿瘤 5 8例 ,占 43 9%。而同期非老年组恶性肿瘤发生率是 5 5 % (10 3/ 186 3) ,老年组恶性肿瘤的发生率显著高于非老年组 (Ｐ <0 0 0 1)。1 2　年龄分布与绝经年龄　本组年龄分布为 :6 1～ 6 4岁6 1例 (占 46 2 % ) ,6 5～ 6 9岁 5 3例 (占 40 2 % ) ,70～ 74岁18例 (占 1…     

磁共振成像及彩色多普勒超声在子宫内膜癌术前分期中的应用

1　资料与方法1 1　研究对象　我院 1997年 8月至 2 0 0 0年 8月收治子宫内膜癌 3 7例 ,均无使用激素史 ,并经病理确诊为子宫内膜癌 ,年龄 4 6～ 68岁 ,平均 ( 5 1 6± 3 8)岁。患者临床分期均在Ⅱｂ以内 ,无内科合并症及手术禁忌证。临床分期及手术病理分期分别采用 1982年及 1989年ＦＩＧＯ分期法。1 2　研究方法1 2 1　术前子宫ＭＲＩ及Ｂ超检查　采用美国ＧＥ公司生产的ＳｉｇｎａＨｏｒｉｚｏｎＥｃｈｏｓｐｅｅｄ 1 5Ｔ超导ＭＲ扫描仪 ,检查前患者阴道填塞纱布 ,膀胱适当充盈 ,采用盆强相控振线圈。图像检查包括平扫矢状位自旋回波…     

晚期子宫内膜癌20例复发转移特征及相关因素分析

目的　探讨晚期子宫内膜癌复发特征及其相关因素。方法　回顾性分析 1989年 8月至 2 0 0 1年 5月间收治的 2 0例晚期子宫内膜癌复发患者临床病理资料 ,并与同期未复发患者进行比较。结果　① 6 0例晚期子宫内膜癌患者 ,随访 1～ 7年 ,发现复发转移 2 0例 ,复发率 33 3% ,其中Ⅲ期 13例 ,Ⅳ期 7例 ;②复发转移首发部位 :盆腹腔 9例 ,肺转移 8例 ,其他部位 3例 ;③临床特征 :Ⅲc和Ⅳ期复发率分别为 4 0 9%和 6 3 6 % ,显著高于Ⅲa(12 5 % ) (P <0 0 5 ) ;术后有残存病灶者复发率为 72 7% ,无残存者仅为 2 4 5 % ,差异有显著性意义 (P <0 0 5 )。④病理特征 :复发率在侵肌≥ 1/ 2者为 5 0 0 % ,侵肌 <1/ 2者为 18 7% ,有宫旁受侵者为 5 8 3% ,而未受侵害者为2 7 1% ,差异均有统计学意义 (P <0 0 5 ) ;低分化癌的复发率 (5 5 0 % )显著高于中分化癌 (2 5 0 % )和高分化癌(2 0 0 % ) (P <0 0 5 ) ;而淋巴结有癌转移的复发率 (46 2 % )和无癌转移者 (2 3 5 % )差异无显著性意义 (P >0 0 5 ) ;⑤复发与治疗方式 :术后辅助化疗和放疗的复发率最低 (13 3% ) ,其次为术后辅助化疗 (31 8% )。结论　晚期子宫内膜癌复发率高 ,最常见的复发转移部位为盆腹腔和肺 ,多数在 2年内复发 ,复发转移高危因素有     

p53及细胞周期素D1在子宫内膜癌中的表达及意义

目的　探讨 p5 3及细胞周期素D1(cyclinD1)在子宫内膜癌中的表达及其临床意义。方法　 1998～2 0 0 2年采用免疫组化LSAB法检测 4 2例子宫内膜癌中 p5 3、cyclinD1的表达。结果　 4 2例子宫内膜癌中 19例p5 3表达阳性 ,占 4 5 2 % ,p5 3与子宫内膜癌的细胞分级、肌层浸润深度有关 ( P<0 0 5 )。 17例子宫内膜癌cyclinD1表达阳性 ,占 4 0 5 % ,cyclinD1与子宫内膜癌的细胞分级、临床分期、淋巴结转移有关 (P <0 0 5 )。p5 3、cyclinD1协同表达 15例 ,均为晚期或低分化癌。结论　p5 3、cyclinD1作为细胞周期调节因子参与子宫内膜癌的发生、发展 ,其协同作用促进子宫内膜癌的发展、且预后不良     

45岁以下子宫内膜癌患者的临床分析

目的　总结 45岁以下子宫内膜癌患者的临床特点。方法　回顾性分析北京协和医院52例 45岁以下子宫内膜癌患者的临床资料 ,并将其分为≤ 3 5岁年龄组 (A组 ,17例 )与 3 5～ 45岁年龄组 (B组 ,3 5例 )进行比较分析。结果　 45岁以下内膜癌患者占内膜癌总数的 12 7% ,随年龄的增加 ,发病人数有增加的趋势 ,约 50 %的患者合并未产、不育、月经失调、子宫内膜增生 ,2 9%合并肥胖 ,2 3 %合并多囊卵巢 ,其中A组合并多囊卵巢的比例为 53 % ,合并内膜不典型增生的比例为 59% ,较B组明显增高 (分别为 9%、2 6% ) ,差异有显著性 (P <0 0 5)。按国际妇产科联盟 (FIGO)标准手术病理分期Ⅰ期占 82 % ,其中A组均为Ⅰ期子宫内膜样腺癌 ;B组有高危因素的患者比例占 2 6% ,但除了分期有升高的趋势 (P <0 0 5)外 ,其余差异均无显著性 (P >0 0 5)。治疗以手术为主 ,另有 2例患者采用孕激素治疗保留生育功能 ,获得缓解。 2例复发。结论　 45岁以下子宫内膜癌患者多合并不育、月经失调、内膜增生、肥胖、多囊卵巢 ,表明其发生与雌激素有关 ;期别以Ⅰ期为主 ,尤其是≤ 3 5岁者 ,高危因素少 ,预后较好。对于早期 (Ⅰa期 ) 45岁以下内膜癌患者可考虑保留生育功能或卵巢     

Profile of women 45 years of age and younger with endometrial cancer

Objective: The clinical characteristics and outcomes of endometrial cancer patients 45 years of age and younger were compared with those of patients older than 45 years of age.Methods: We performed a cross-sectional study of 301 consecutive endometrial cancer patients referred to our center from 1989 to 1994. Of the 289 patients eligible for study, 40 were 45 years of age or younger (group A) and 249 were older than 45 years of age (group B).Results: The majority of patients in both groups presented with stage I disease. Of the women with stage I disease, patients in group A were more likely than those in group B to have low-grade disease localized to the endometrium (P < .001; relative prevalence 3.39; confidence interval [CI] 1.88, 6.12). However, the distribution of stages I to IV overall was the same for the two groups (P = .269). Although univariate analysis revealed that 11% of the patients in group A and 2% in group B had synchronous ovarian malignancies (P = .007; relative prevalence 5.42; CI 1.39, 21.14), multivariate logistic regression found that nulliparity, not age, was an independent risk factor for synchronous ovarian malignancy (P = .017; relative prevalence 6.15; CI 1.52, 25.61). There were no statistically significant differences by age in the prevalence of high-risk endometrial histology (serous and clear cell carcinoma) or in survival.Conclusion: The overall distribution of tumor stage and survival were the same for the younger and older women; this finding contradicts previous reports that suggest that young women with endometrial cancer are at lower risk. Additionally, nulliparity, which occurs with a higher prevalence in younger women who develop endometrial cancer, is associated statistically with the development of synchronous ovarian malignancies.     

The significance of local cellular immune response of women 50 years of age and younger with endometrial carcinoma

OBJECTIVE: Local cellular immune response and traditional histopathologic parameters in endometrial carcinoma patients 50 years old and younger were compared with those of patients older than 50 years of age. MATERIALS AND METHODS: We retrospectively compared the clinicopathologic factors and outcomes of 24 younger and 82 older women who were operated on for endometrioid type endometrial carcinoma at our institution. RESULTS: No significant difference was determined in survival with respect to age and menopausal status in patients with endometrial carcinoma. Younger and older age groups had a similar distribution of most pathologic features including myometrial invasion, cervical involvement, lymph node metastasis, vascular invasion, perivascular lymphocytic infiltrates and tumor infiltrating lymphocytes. While older women had higher-grade tumors, younger women had more frequent ovarian metastasis. Tumor infilrating lymphocytes were seen more frequently in the postmenopausal group than those of the premenopausal group. CONCLUSION: The distribution of local cellular immune response, most histopathologic parameters and survival were the same for younger and older women.     

子宫内膜腺鳞癌临床病理特征及其预后研究

目的 探讨子宫内膜腺鳞癌患者的临床病理特征及预后。方法 选取1992年3月至2004年12月北京大学人民医院就诊的子宫内膜癌患者,分为普通子宫内膜样腺癌组、腺鳞癌组以及浆液性乳头状腺癌和透明细胞癌组进行回顾性研究。结果 腺鳞癌患者9例,占同期210例内膜癌患者的4.3%。普通子宫内膜样腺癌组与腺鳞癌组肿瘤分期差异无显著性意义（P〉0.05）;浆液性乳头状腺癌和透明细胞癌患者肿瘤分期明显晚于子宫内膜样腺癌患者（P〈0.05）。腺鳞癌组深肌层及浆膜层浸润较普通子宫内膜样腺癌组多,分别为6/9和32.6%（62/190）,但差异无显著性意义（P〉0.05）。腺鳞癌组与普通子宫内膜样腺癌组患者肿瘤细胞分化程度差异无显著性意义（P〉0.05）。18例（9.5%）普通子宫内膜样腺癌患者、1例（1/9）腺鳞癌患者以及4例（4/11）浆液性乳头状腺癌和透明细胞癌患者因癌死亡,子宫内膜样腺癌患者因癌死亡比例明显低于浆液性乳头状腺癌和透明细胞癌患者（P〈0.05）,而普通子宫内膜样腺癌组与腺鳞癌组差异无显著性意义（P〉0.05）。生存分析显示接受手术治疗的腺鳞癌患者,其预后与肿瘤分期相关（P〈0.05）。结论 子宫内膜腺鳞癌临床病理特征及预后与普通子宫内膜样腺癌无明显区别,而与浆液性乳头状腺癌和透明细胞癌不同。     

Use of the Cornier pipelle as the only means of presurgical histologic diagnosis in endometrial carcinoma: agreement between initial and final histology

OBJECTIVE: To test the reliability of the Cornier pipelle as a diagnostic tool for submitting endometrial carcinoma patients directly to surgery, without the additional performance of dilatation and curettage. METHODS: In this prospective study, 56 consecutive patients with the presumptive diagnosis of endometrial carcinoma, based on the analysis of material sampled by means of microcurettage using the Cornier pipelle, were submitted to hysterectomy. The findings of the final pathological report were compared with those of the previous microcurettage. Both were analysed at the same Pathology laboratory throughout the study. The presence of endometrial carcinoma was confirmed intraoperatively in all cases, and, as a consequence, a staging laparotomy was completed in all of them. RESULTS: Although the initial diagnosis of carcinoma was confirmed in every case (100% sensitivity), the final pathological report revealed discordant histological subtypes in 6 out of the 56 cases (10.7%). Only two, however, represented higher histological risk than initially stated. Discrepant grading values were also found in 3 out of 41 (7.3%) cases of the endometrioid subtype for which tumor grade been established in the microcurettage specimen. Not performing dilatation and curettage under general anesthesia prior to surgery resulted in a significant saving, both in hospitalization costs and bed occupation. CONCLUSION: When endometrial sampling by means of the Cornier pipelle yields the diagnosis of carcinoma, it can be confidently relied upon. However, some high-risk cases can be missed due to discordance between initial and final histology, and this could eventually lead to the choice of an inadequate surgical strategy.     

Ets-1在子宫内膜癌中的表达及意义

目的:探讨Ets-1在子宫内膜癌组织中的表达及其与临床分期、病理分级、分型及预后的关系。方法:免疫组化SP法检测子宫内膜癌及正常子宫内膜组织中Ets-1表达,荧光原位杂交法检测Ets-1 mRNA表达。结果:子宫内膜癌组织中Ets-1蛋白阳性表达率为88.8%,高于正常子宫内膜。子宫内膜癌组织中Ets-1表达与临床病理分期、肌层浸润与病理分级有关,差异有统计学意义(P<0.05)。结论:Ets-1与子宫内膜癌的临床分期、病理分级、转移密切相关。     

HE4在子宫内膜癌诊断中的应用价值探讨

目的:探讨血清人附睾蛋白4(HE4)检测在子宫内膜癌诊断中的价值。方法:用ELISA法对30例子宫内膜癌(子宫内膜癌组)和403例同期体检的健康妇女(正常对照组)血清HE4浓度进行检测。结果:子宫内膜癌组血清HE4为97.12±51.12pmol/L,正常对照组为40.04±9.59pmol/L,子宫内膜癌组显著高于正常对照组(P<0.01)。子宫内膜癌组中,血清HE4水平在不同患者年龄、病灶范围大小、肌层浸润深度等方面比较,差异有统计学意义(P<0.05),而在肿瘤的分化程度、组织学类型及临床分期方面比较,差异无统计学意义(P>0.05)。正常对照组中,380例60岁以下组血清HE4水平为39.45±8.90pmol/L,23例60岁以上组血清HE4水平为49.79±14.49pmol/L,两者比较差异有高度统计学意义(P<0.01)。结论:HE4检测对子宫内膜癌的诊断及预后判断有一定的价值。     

Clinicopathologic analysis of the prognostic factors in women with coexistence of endometrioid adenocarcinoma in the endometrium and ovary

AIM: To compare the survival and prognostic factors of patients with dual primary ovarian and endometrial cancers (primary group), and endometrial cancers metastatic to the ovaries (metastatic group). METHODS: Thirty-six patients with gross tumors confined to the pelvis and of endometrioid adenocarcinoma subtype in both the endometrium and ovary were selected from our file of 546 Japanese women with endometrial carcinoma. The patients were divided into two groups. Eleven were classified into the primary group. Twenty-five were classified into the metastatic group. Both univariate and multivariate regression analyses were carried out. RESULTS: The mean age of the primary group was significantly younger than that of the metastatic group (45.2 years vs 51.2 years; P < 0.01). The cumulative 10-year survival of the primary group was significantly better than that of the metastatic group (90.9%vs 46.6%; P < 0.05). Univariate analyses showed that older age (P < 0.05) and the presence of lymphovascular space invasion (LVSI; P < 0.004) of the tumor of the uterus were significantly associated with a poor prognosis in the metastatic group. Multivariate analysis including the above variables showed no independent prognostic factor (older age, P < 0.60 and LVSI, P < 0.06). CONCLUSION: When encountering women with coexisting endometrioid carcinoma in the endometrium and ovary with gross tumor limited to the pelvis, more attention should be paid to LVSI of the tumor of the uterus as a poor prognostic indicator.     

The effect of increasing age on the outcome of hysteroscopic endometrial resection for management of dysfunctional uterine bleeding

STUDY OBJECTIVE: To determine the outcome of hysteroscopic endometrial resection for dysfunctional uterine bleeding according to women's age. DESIGN: Long-term follow-up by telephone interview (Canadian Task Force classification II-2). SETTING: University-affiliated medical center. Patients. One hundred sixty-nine women with abnormal uterine bleeding unresponsive to conservative medical management. INTERVENTION: Hysteroscopic endometrial resection. MEASUREMENTS AND MAIN RESULTS: Questionnaires were completed for 162 (95.9%) patients with mean +/- SD follow-up of 32 +/- 17 months. The frequency of postoperative complications was not related to age. After ablation, the rate of amenorrhea was significantly higher in 31 women age 50 years or older than in younger women (p <0.001), and also in 72 women age 45 to 49 than in 59 age 44 or less (p <0.05). Complete relief of dysmenorrhea was achieved significantly more often in women age 45 to 49 (p <0.005) and 50 or older (p <0.05) than in those age 44 or younger. Dissatisfaction with the outcome of endometrial resection was uncommon, but most frequent among women age 44 or younger (p <0.10). There was no difference in the proportion of women requiring second ablation or hysterectomy in any age group. CONCLUSION: Significantly higher rates of amenorrhea and complete relief of dysmenorrhea after endometrial resection are achieved in older than in younger women.     

Endometrial carcinoma in premenopausal women: A clinicopathological study

A clinicopathological review of 106 cases of premenopausal endometrial carcinoma has confirmed the good prognosis in such patients. Women less than 40 years old were more likely to be nulliparous, over 80 kg in weight, and to present with irregular or heavy and irregular bleeding, than women 40 years or older. Seven patients developed malignancies at other sites. A detailed pathological review of 32 cases revealed poor prognostic features in 30% of patients; corpora lutea were identified in the ovaries of 13 patients. It is suggested that factors other than anovulation are related to the development of endometrial cancer in the over 40 age group.