子宫内膜癌临床病理特征与盆腹腔淋巴结转移的相关性分析

目的:探讨子宫内膜癌临床病理特征与盆腹腔淋巴结转移的相关性。方法:选取162例子宫内膜癌患者,分析临床病理资料,探讨盆腹腔淋巴结转移的相关因素。结果:162例子宫内膜癌患者中,9例发生盆腔淋巴结转移,7例发生腹主动脉旁淋巴结转移。非内膜样腺癌、FIGO Ⅲ 期、脉管浸润、治疗前CA125高于正常水平的患者盆腔淋巴结转移率高,差异有统计学意义;FIGO Ⅲ 期、脉管浸润、肿瘤直径>2 cm、治疗前CA125水平高于正常及盆腔淋巴结阳性的患者腹主动脉旁淋巴结转移率高,差异有统计学意义。多因素COX回归分析:FIGO分期、病理类型、脉管浸润为淋巴结转移的高危因素。结论:非子宫内膜样腺癌、FIGO分期、脉管浸润、治疗前CA125高水平与子宫内膜癌盆腔淋巴结转移存在相关性,FIGO分期、脉管浸润、肿瘤直径、治疗前CA125水平、盆腔淋巴结与子宫内膜癌腹主动脉旁淋巴结转移存在相关性。     

子宫内膜癌临床病理特点与淋巴结转移的相关性分析

目的 探讨子宫内膜癌临床病理特点与淋巴结转移的相关性.方法 选取76例子宫内膜癌患者为研究对象,分析该类患者的临床病理资料特点,并探究其与淋巴结转移的相关性.结果 76例中有15例子宫内膜癌患者发生淋巴结转移,淋巴结转移的影响因素有宫颈受累、肌层浸润、脉管浸润、病理类型及病理分期等.结论 肌层浸润或脉管浸润程度深,病理分期程度低以及宫颈受累与子宫内膜癌患者淋巴结转移密切相关.     

子宫内膜癌147例临床分析

目的：探讨子宫内膜癌的治疗及预后相关因素。方法：回顾性分析我科1991～1997年收冶的147例子宫内膜癌患者的临床病理资料，并全部随访。结果：147例患者、平均年龄56．1岁；5年生存率72．8％；临床表现不规则阴道出血135例、盆腔包块81例、白带增多38例及腹痛23例；绝经前病例为39．5％，已占相当比例，有年轻化趋势；临床病理分期愈晚，预后愈差；肌层侵犯的深度与淋巴结转移及病理组织学分级密切相关，深肌层浸润者，易淋巴结转移、病理组织学分级也差；手术为主、放疗、化疗为辅助治疗的综合治疗预后好、并发症少；孕激素对改善预后有一定的价值。结论：以手术为主的综合治疗是目前治疗子宫内膜癌的首选治疗措施；绝经前后的妇女出现不规则阴道出血等非特异性的妇科症状时，必须警惕子宫内膜癌的发生；临床病理分期、肌层浸润深度、病理组织学分级、淋巴结转移情况及孕激素的应用都是影响预后的相关因素。     

临床Ⅰ期子宫内膜癌患者的卵巢转移问题

目的研究临床Ⅰ期子宫内膜癌患者卵巢转移的发生率,以期为年轻内膜癌患者的卵巢保留手术提供依据。方法回顾性收集并分析1994年1月至2002年12月期间在重庆医科大学附属二院妇产科首诊并行手术治疗的子宫内膜癌患者的临床病理资料。结果52例术前诊断为临床Ⅰ期子宫内膜癌患者中,FI-GO手术-病理分期:Ⅰ期47例,Ⅱ期3例,Ⅲ期2例;2例Ⅲ期患者中,1例有子宫浆膜累及,1例有镜下输卵管种植转移,卵巢转移率为3.9%(2/52)。结论高分化及中分化、浅肌层浸润(<1/2)、腹水细胞学阴性、淋巴结无转移的临床Ⅰ期子宫内膜癌患者的卵巢转移的风险较低,这些年轻内膜癌患者是否切除卵巢,尚需在手术标本病理检查后决定。     

子宫内膜癌脐转移一例

子宫内膜癌脐转移一例张彦娜李孟达关键词子宫肿瘤脐部肿瘤／继发性中图号Ｒ７３７．３３一般认为，子宫内膜癌以直接浸润为其主要的转移方式，淋巴转移较少见，而脐转移极为罕见。本文报告子宫内膜乳头状腺癌脐转移一例。患者，６３岁，因绝经１１年，阴道不规则流血性液...     

子宫内膜癌临床病理特征与盆腔淋巴结转移的相关性

目的 探讨子宫内膜癌临床病理特征与盆腔淋巴结转移的相关性.方法 选取100例子宫内膜癌患者为研究对象,分析患者临床病理特征及其与盆腔淋巴结转移的相关性.结果 19例子宫内膜癌患者出现盆腔淋巴结转移,盆腔淋巴结转移与子宫内膜癌病理类型、病理分期、宫颈受累及肌层浸润、脉管浸润等有关(P＜0.05).结论 子宫内膜癌病理类型为非内膜样癌、肌层浸润及脉管浸润程度深、病理分期程度低及宫颈受累与盆腔淋巴结转移存在相关性.     

45岁以下子宫内膜癌的临床病理分析

年龄<45岁的妇女子宫内膜癌常很少被妇科及病理学者所怀疑。现将我院1979～1989年所见28例进行临床和病理复习。发病率为8.8%。临床特征包括:平均年龄37.8岁,初潮延迟,月经紊乱。术前常识诊为功能性子宫出血和子宫肌瘤。病理所见:肿瘤直径>1.5cm,脉管转移率约25%。作者强调早期诊断必需采用诊断性分段诊刮,特别是对月经紊乱者。     

子宫内膜癌卵巢转移的危险因素分析

[目的]探讨子宫内膜癌患者发生卵巢转移的危险因素。[方法]回顾性分析1995年1月至2009年12月的489例子宫内膜癌患者的临床病理资料,采用SPSS16.0软件单因素分析和多因素Logistic分析其卵巢转移的危险因素。[结果]489例子宫内膜癌患者中,39例卵巢转移,发生率为7.98%（39/489）。Logistic回归分析显示,盆腔其他部位转移、腹主动脉旁淋巴结阳性和脉管瘤栓是子宫内膜癌发生卵巢转移的独立危险因素。[结论]子宫内膜癌保留卵巢存在一定风险,但是对于强烈要求保留卵巢功能的患者,在仔细评估卵巢转移高危因素后可保留卵巢。     

52例子宫内膜癌的盆腔淋巴结转移分析

为了探讨子宫内膜癌发生盆腔淋巴结转移的高危因素,我们对５２例做盆腔淋巴清扫的子宫内膜癌病例作回顾性分析,现报告如下。１临床资料１．１一般资料１９９４年１月至１９９７年７月对５２例子宫内膜癌患者行盆腔淋巴清扫的手术治疗。按宫颈癌的盆腔淋巴清扫术式做盆腔...     

青年子宫内膜癌和老年子宫内膜癌临床和病理特点分析

目的通过对妇科相对较少见的青年子宫内膜癌与老年子宫内膜癌的临床和病理特点分析,以提高确诊率,减少误诊,漏诊率。方法对1980～1997年间收治的青年子宫内膜癌27例（≤40岁）,老年子宫内膜癌30例（≥70岁）的特点进行回顾性对比分析。结果青年子宫内膜癌以不规则阴道出血为主要症状,伴原发性不孕者40．74％,卵巢异常增大者59．26％,病理诊断为卵巢滤泡囊肿者48．15％。无症状者占15％。以雌激素相关型子宫内膜癌为主,肌层浸润相对较少,分化较好。老年子宫内膜癌以绝经后阴道出血为主要症状。多数与雌激素和增生无关,肿瘤恶性高,分化差。结论青年子宫内膜癌与子宫内膜增殖症,不典型增生较难区分,诊断时应特别慎重。老年子宫内膜癌如能早发现．掌握手术适应症,仍能收到较为满意的效果.     

Nasopharyngeal carcinoma with brain metastasis: A case report

Summary We report a case of nasopharyngeal carcinoma with brain metastasis of a 69-year-old man. The patient presented with blindness and a huge mass over right upper neck. The magnetic resonance imaging (MRI) showed right nasopharyngeal tumor and metastatic lesion in bilateral occiptal regions. The bony x-ray showed diffuse osteoblastic metastases. The brain lesion was pathology-proven through the computed-tomographic guidance sterotatic biopsy.     

Rare presentation of endometrial carcinoma with singular bone metastasis

ARTIOLI G., CASSARO M., PEDRINI L., BORGATO L., CORTI L., CAPPETTA A., LOMBARDI G. & NICOLETTO M.O. (2010) European Journal of Cancer Care 19 , 694–698 Rare presentation of endometrial carcinoma with singular bone metastasis The major symptom at diagnosis of endometrial cancer is post‐menopausal bleeding; it is present in around 90% of cases. Singular bone metastasis is described as an uncommon site for endometrial cancer at diagnosis, showing in just 5–6% of cases. In this report we describe a rare presentation of a singular bone metastasis because of endometrial cancer of a woman with previous diagnosis of early breast cancer. A review of literature uncovered some cases of bone metastasis at presentation of endometrial cancer and that it can occur as first symptom of cancer before vaginal bleeding. This rare presentation of uterine cancer needs to be studied and described because it may be seen and needs a homogeneous treatment to improve survival.     

Management of brain metastases from ovarian and endometrial carcinoma with stereotactic radiosurgery

BACKGROUND

Metastases to the brain from ovarian and endometrial carcinoma are uncommon and to the authors' knowledge consensus regarding optimal management is lacking. Stereotactic radiosurgery (SRS) has proven useful for the treatment of many benign and malignant brain tumors. In the current study, the authors evaluated outcomes after SRS in patients with ovarian and endometrial carcinoma.

METHODS

Twenty‐seven patients with brain metastases underwent gamma–knife SRS. Six patients had endometrial carcinoma, whereas 21 patients had ovarian carcinoma. Eighteen patients also received whole–brain radiotherapy. A total of 68 tumors were treated with gamma–knife SRS.

RESULTS

At the time of last follow–up, 1 patient was still alive and 26 had died. The median survival was 7 months after the initial diagnosis of brain metastasis and 5 months after SRS. The 1‐year survival rate after radiosurgery was 15% and that from the diagnosis of brain metastases was 22%. On final imaging, all tumors were controlled without further growth. Two patients (7.4%) developed new or progressive neurologic deficits after SRS.

CONCLUSIONS

SRS is an acceptable choice for the treatment of brain metastases resulting from ovarian and endometrial carcinoma, and provides local tumor control with limited morbidity. Careful patient selection is warranted in the setting of patients with uncontrolled systemic disease in whom a limited survival benefit is expected. Cancer 2008. © 2008 American Cancer Society.     

子宫内膜细胞学检查在子宫内膜癌筛查中的临床应用价值

目的:研究子宫内膜细胞学检查（endometrial cytology test,ECT）在子宫内膜癌(endometrial carcinoma,EC)筛查中的临床应用价值。方法:选取2016年10月至2017年09月就诊于我院肿瘤妇科的150例患者,随机分成两组,其中一组行细胞学检查的同时行诊断性刮宫术,另一组只行诊断性刮宫术。结果:以诊断性刮宫的病理结果作为“金标准”,子宫内膜细胞学检查的灵敏度为91.49％,特异度为96.43％,阳性预测值为97.73％,阴性预测值为87.10％,诊断符合率为93.33％,与诊断性刮宫相比差异无统计学意义（χ2=0.8,P>0.05）。结论:子宫内膜细胞学检查结果与诊断性刮宫基本一致,且取材满意度高、痛苦小、出血少,可以作为筛查子宫内膜癌的一线方法。     

恶性肿瘤特异生长因子和肿瘤浸润性树突状细胞在子宫内膜癌患者中的表达及临床意义

目的:探讨恶性肿瘤特异生长因子(TSFG)和肿瘤浸润性树突状细胞(TIDC)在子宫内膜癌患者中的表达及临床意义。方法:选择2015年1月至2017年1月我院收治的子宫内膜癌患者50例。检测子宫内膜组织中TIDC和血清中TSFG水平,分析TSFG、TIDC在不同临床病理特征患者中的表达。结果:与癌旁组织比较,肿瘤组织中TIDC明显降低(P=0.000);MHC-Ⅱ阳性树突状细胞（DC）(%)明显降低（P=0.000);CD54阳性DC(%)明显降低（P=0.000)。与非淋巴结转移的患者相比,淋巴结转移的患者TIDC、MHC-Ⅱ阳性DC(%)、CD54阳性DC(%)均明显降低,TSFG明显增高(P<0.05)。与临床TNM分期为Ⅰ或Ⅱ期的患者相比,Ⅲ或Ⅳ期的患者TIDC、MHC-Ⅱ阳性DC(%)和CD54阳性DC(%)均明显降低,TSFG明显增高(P<0.05)。与肌层浸润≤1/2的患者相比,肌层浸润>1/2的患者TIDC、MHC-Ⅱ阳性DC(%)和CD54阳性DC(%)均明显降低,TSFG明显增高(P<0.05)。与中、高分化的患者相比,低分化患者组织中TIDC、MHC-Ⅱ阳性DC(%)和CD54阳性DC(%)均明显降低,TSFG明显增高（P<0.05）。结论:TIDC在肿瘤组织中低表达,且多为不成熟的调节性DC细胞。低分化、TNM分期为Ⅲ或Ⅳ期、淋巴结发生转移、肌层浸润>1/2的患者血清中TSFG水平明显升高,而肿瘤组织中TIDC明显降低。提示子宫内膜癌患者血清中TSFG和肿瘤组织中TIDC可作为判断预后的指标。     

Increasing incidence of brain metastasis in patients with advanced hepatocellular carcinoma in the era of antiangiogenic targeted therapy

Aim.

Brain metastasis was regarded, until recently, as a rare and late-stage event in patients with hepatocellular carcinoma (HCC). With the prolongation of survival in patients with advanced HCC by molecular targeted agents, this may have changed. We aimed to examine whether or not the incidence of brain metastasis in these patients has increased.

Methods.

Between June 2005 and May 2009, 158 advanced HCC patients in total with either metastatic or locally advanced disease untreatable by locoregional therapies were enrolled in clinical trials of first-line antiangiogenic therapies. The clinicopathologic features and survival times of those who developed brain metastasis were analyzed.

Results.

Eleven (7%) of 158 advanced HCC patients, with a median follow-up of 26.6 months, were diagnosed with brain metastasis as a result of compatible symptoms, confirmed by brain imaging. All 11 patients had extrahepatic metastasis upon enrollment, and 10 of them had lung metastasis. The median time to brain metastasis was 9.6 months (range, 0.6–19.6 months). The median overall survival (OS) time after diagnosis of brain metastasis was 4.6 months (range, 0.7–12.6 months). Four patients received brain tumor excision, and their survival duration after brain metastasis tended to be longer than that of those who did not (median OS time, 6.1 months versus 3.1 months).

Conclusions.

In the era of antiangiogenic targeted therapy, the importance of brain metastasis for advanced HCC patients may have increased.     

Carcinoma of the prostate with brain metastasis

Brain metastasis from prostatic carcinoma is considered rare and usually is diagnosed at postmortem examination. The authors reviewed the tumor registry of 1314 patients with proven diagnosis of prostatic carcinoma seen at Hines VA Hospital from January 1963 to December 1978 and found that 8 of the 1314 patients (0.6%) had brain metastasis. Six of eight patients (75%) were diagnosed having brain metastasis at premortem and of these, two patients presented with brain metastasis before diagnosis of prostatic carcinoma was made. Two of four patients who received palliative whole brain irradiation survived more than 1.5 years. It is our belief that patients with prostatic carcinoma who have symptoms of brain metastasis should be worked up and given palliative whole brain irradiation.