子宫内膜和卵巢双原发癌二例报告

子宫内膜和卵巢双原发癌二例报告莱州市人民医院（莱州市２６１４００）刘志芳李节良宫兆松１病例报告例１．患者５５岁，因绝经３年，阴道不规则流血２个月行刮宫活检，病理诊断为子宫内膜腺癌，于１９９３年３月１６日入院。既往身体健康，孕３产３，末次月经１９９０年...     

子宫内膜和卵巢部位双原发癌中端粒长度检测及同源性研究

目的：探讨宫腔子宫内膜样腺癌和卵巢子宫内膜样腺癌（双原发癌）两部位癌组织是否有同源性。方法：收集青岛大学医学院附属医院妇科2005-01-01-2013-01-01收治的16例子宫内膜和卵巢双原发癌患者的癌组织切除标本,采用荧光定量PCR法分别检测同一患者子宫内膜部位癌组织和卵巢部位癌组织中端粒DNA的相对表达量,并采用免疫组化PV-6000二步法分别检测免疫表型雌激素受体（estrogen receptor,ER）和孕激素受体（progesterone receptor,PR）的表达。结果：16例患者子宫内膜部位癌组织端粒相对长度（3.601±1.497）与卵巢部位癌组织端粒相对长度（3.71±1.556）相近,差异无统计学意义,t=1.423,P=0.175。子宫内膜和卵巢两部位癌组织ER蛋白表达相同10例（62.5%）,其中ER蛋白均阳性表达9例（56.25%）,均阴性表达1例（6.25%）;表达不同6例（37.5%）,差异无统计学意义,P=0.06;PR蛋白表达相同9例（56.25%）,其中PR蛋白均阳性表达8例（50.00%）,均阴性表达1例（6.25%）;表达不同7例（43.75%）,差异无统计学意义,P=0.09。结论：宫腔子宫内膜和卵巢两部位癌组织的子宫内膜样腺癌中,两部位癌组织的端粒长度相近,ER和PR在两部位癌组织中的表达也相似。由此推断两部位癌组织可能存在同源性,需进一步研究证实。     

子宫内膜和卵巢双原发癌的研究进展

子宫内膜和卵巢双原发癌( synchronous endometrial and ovarian carcinoma, SEOC)的概念在上世纪八十年代被 Ul-bright等[1]提出,病因及发病机制不明确.SEOC诊断困难,主要是因为病理诊断标准复杂,难以与子宫内膜癌卵巢转移( endometrial carcin...     

乳腺卵巢双原发癌21例临床分析

[目的]探讨乳腺与卵巢双原发癌的临床特点。[方法]分析21例乳腺卵巢双原发癌患者的发病年龄、两癌发病间隔、病理类型、分期、家庭史和生存期。[结果]21例患者的中位生存期为69个月，2、5年生存率分别为40.0%和13.3%。两癌发病间隔≥5年者7例（占33.3%）。卵巢癌的中位发病年龄为49岁，55岁前发病者占61.9%；病理类型以浆液性腺癌最常见（占72.6%），Ⅲ期71.4%，低分化者61.9%。[结论]乳腺与卵巢双原发癌的卵巢癌发病年龄比散发者早，多数为晚期，病理类型以低分化为主。手术为主要治疗手段。     

子宫内膜与卵巢双原发癌临床病理分析

目的 探讨子宫内膜与卵巢双原发癌的临床病理特点、治疗和预后。方法 回顾性分析12例子宫内膜与卵巢双原发癌,其中两个部位均为子宫内膜腺癌者8例,两个部位是两种完全不同的病理类型者4例。结果 子宫内膜与卵巢双原发癌术前诊断困难,12例均经术后病理确诊。其特点为：卵巢肿瘤体积较小,平均7cm;原发不孕比例高（40．7％）;早期居多,两部位均为I期者8例（66．7％）;病理类型以子宫内膜样癌最多见（66．7％）。所有病例均行手术和化疗,3年生存率为66．7％（8／12）。结论 子宫内膜与卵巢双原发癌是有别于原发性子宫内膜癌或卵巢癌的一种特殊类型的肿瘤,一般发现早,预后较好。     

卵巢子宫内膜样癌：附13例临床分析

卵巢子宫内膜样癌是组织学相似于子宫内膜癌的卵巢上皮性恶性肿瘤,分３种,即卵巢子宫内膜样癌、卵巢子宫内膜间质肉瘤、卵巢中胚混合瘤［１］。其中以卵巢子宫内膜样癌最为常见。分析我院收治的卵巢子宫内膜样癌１３例,现报道如下。１临床资料作者单位：山东省单县中心...     

子宫内膜腺鳞癌51例临床预后分析

目的通过对子宫内膜腺鳞癌临床特征的分析,探讨影响预后的因素。方法回顾性研究1997年7月至2007年5月湖南省肿瘤医院共收治51例子宫内膜腺鳞癌病人。结果①腺鳞癌占同期全部宫内膜癌的4．78％,腹膜后淋巴结转移率14．0％。②肌层浸润〈1／2与〉1／2的宫外转移率分别为26％和62．5％,差异具有显著性（P〈0．05）。③单因素线性回归分析显示：腺癌分化程度与浸润肌层深度有关（P=0．035）。④Ⅰ期5a生存率85．7％,Ⅲ期5a生存率66．7％,而Ⅳ期2a生存率分别为33．3％。结论子宫内膜腺鳞癌临床特征与普通子宫内膜样腺癌无明显区别。分化程度和肌层浸润深度是影响其预后的重大因素。     

子宫内膜和卵巢双原癌1例

临床资料患者４４岁 ,住院号１４２７８４ ,孕２产１。因右下腹坠胀不适半月 ,发现盆腔包块４天 ,于１９９９年１２月１日入院。两年前 ,病员因经期延长半年 ,服用宫血宁后恢复正常 ,月经规则（４至６天／２８至３０）至今 ,末次月经１９９９年１１月１７日 ,量中等 ,无痛经。入院前半月 ,感右下腹坠胀 ,仰卧位时明显 ,无大小便困难。４天前 ,Ｂ超发现盆腔肿块。查体见肥胖体型 ,血压１１０／８０ｍｍＨｇ,心肺正常 ,腹平软 ,未触及包块 ,肝脾未扪及 ,移浊阴性。妇科检查见 :外阴、阴道正常 ,宫颈Ⅰ度糜烂 ;子宫后位 ,约２月孕大小 ,质偏软 …     

双原发癌10例临床分析

我们 1995年 8月— 1999年 6月收治了 10例双原发癌患者 ,约占同期癌症患者的 0 .74% ,这些病例经积极治疗有3例生存期达到 3年 ,绝大部分提高了生存质量 ,并延长了生存时间。现将结果并文献复习报道如下。1　材料与方法1.1　双原发癌的诊断标准　双原发癌是指同一患者不同部位同时或先后发生两种组织学不同的原发性恶性肿瘤。若两种恶性肿瘤在 6月内先后发生的称为同期发生 ;6月以上先后发生的称为异期发生。并根据 Warren及 Gates标准 ,确定双原发癌诊断标准如下 :1第 1个肿瘤组织学上必须是恶性肿瘤 ;2每个肿瘤有其独特的病理形态 ;3肿…     

Synchronous primary cancers of the endometrium and ovary： review of 43 cases

Objective:To investigate the clinicsl and pathological characteristics.treatment methods,and prognosis of synchronous primary cancer of the endometrium and ovary.Methods:The clinical data of 43 patients with synchronous primary cancer of endometrium and ovary were retrospectively reviewed.The survival was calculated by Kaplan-Meier method and compared using the log-rank test.Results:The median age of the patients at diagnosis was 49 years(range.28-73 years).The most common symptoms were abnormal vaginal bleeding(69.8%)and abdominal or pelvic pain(44.2%).Pelvic masses were found in 39.5%of the patients and enlarged corpus in 27.9%at physic examination.while pelvic masses were found in 67.4%of the 43 patients(29 cases)and thickening or abnormal endometrium in 23.3%(10 cases)during ultrasound exami-nation.Of 25 patients examined by CT/MRI.pelvic masses were found in 13 cases and enlarged uterus in 11 cases.All 15 patients who underwent endometriaI biopsies were proven to have endometrioid carcinomas.Serum CA125 level was found to be elevated in 22 of the 34 examined cases(64.7%)with median value 500 U/mL(range,39-3439 U/mL).FIGO stages of endometrial carcinomas:ⅠA 18 cases,ⅠB 20 cases.ⅠC 2 cases,and ⅡA 3 cases;Stages of ovarian cardnomas:ⅠA 19 case,ⅠB 4 cases,ⅠC 7 cases.Ⅱ 4 cases,and ⅢC 9cases.Twenty-four patients(55.8%)were in stage Ⅰ both endometrial and ovar-ian carcinomas.Thirty-one patients underwent total hysterectomy plus bilateral salpingo-oophorectomy with omentectomy and appendectomy,meanwhile,12 patients had pelvic lymph nedes dissection.Thirty-eight of the 43 patients(88.4%)had a pathologically proven endometrial adenocarcinomas.The predominant ovarian histologies were endometrioid or mixed tumors with endometrioid components(30/43,69.8%).Postoperatively,26 patients(60.5%)received adjuvant chemotherapy alone.12 had chemotherapy plus radiotherapy,only one patients had radiation alone and the remaining 4 cases received no adiuvant treatment.The 3-year and 5-year survival rates of the group were 87.4%and 71.1%respectively.The 3-year and 5-year survival rates of patients with endometriold carcinoma at both endometrial and ovarian were higher than that of those with non-endometriold or mixed histologic subtypes(93.8%,82% vs 79.7%.69%).The 3-year and 5-year survival rates of patients with earty stages disease were better than those of other patients(93.3%,93.3% vs 69.7%,36.7%).Recurrence developed in 15 patients(34.9%).It was showed by univariate analysis that lower CA125 level,early FIGO stage,and adjuvant chemotherapy plus radiotherapy significantly and positively affected the 5-year survival rate.while only eady FIGO stage and chemotherapy plus radiotherapy were revealed by multivariate analysis as independent prognostic factors.Conclusion:Syn- chronous primary cancers of the endometrium and ovary were different from either the primary endometrial or ovarian cancer,while usually it can be detected in early stage with a good prognosis.The impact of the CA125 level on prognosis needs to be further studied.Surgery treatment alone may be enough for early stage patients.Chemotherapy plus radiotherapy may benecessary for advanced patients.     

Survival outcome of women with synchronous cancers of endometrium and ovary: a 10 year retrospective cohort study

Objective

Synchronous occurrence of endometrial and ovarian tumors is uncommon, and they affect less than 10% of women with endometrial or ovarian cancers. The aim of this study is to describe the epidemiological and clinical factors; and survival outcomes of women with these cancers.

Methods

This is a retrospective cohort study in a large tertiary institution in Singapore. The sample consists of women with endometrial and epithelial ovarian cancers followed up over a period of 10 years from 2000 to 2009. The epidemiological and clinical factors include age at diagnosis, histology types, grade and stage of disease.

Results

A total of 75 patients with synchronous ovarian and endometrial cancers were identified. However, only 46 patients met the inclusion criteria. The median follow-up was 74 months. The incidence rate for synchronous cancer is 8.7% of all epithelial ovarian cancers and 4.9% of all endometrial cancers diagnosed over this time frame. Mean age at diagnosis was 47.3 years old. The most common presenting symptom was abnormal uterine bleeding (36.9%) and 73.9% had endometrioid histology for both endometrial and ovarian cancers. The majority of the women (78%) presented were at early stages of 1 and 2. There were 6 (13.6%) cases of recurrence and the 5 year cumulative survival rate was at 84%.

Conclusion

In our cohort, we found that majority of women afflicted with synchronous cancer of the endometrium and ovary were younger at age of diagnosis, had early stage of cancer and good survival.     

同时发生的原发性子宫内膜癌与卵巢癌2例报告及文献复习

目的:提高对同时发生的原发性子宫内膜癌与卵巢癌的认识。方法:结合文献复习,对2例诊断为同时发生的原发性子宫内膜癌与卵巢癌的诊断、治疗,进行分析。结果:2例患者均为绝经后,以绝经后不规则出血就诊,术前检查发现卵巢占位病变。术后病理确诊为原发性双癌。结论:子宫内膜和卵巢原发性双癌诊断上容易与II期卵巢癌和III期子宫内膜癌混淆,但两者的预后和治疗不同,所以明确区分两者是完全必要的。     

Synchronous double primary lung cancer: a report of three cases

The incidence of synchronous multiple primary lung cancers is on the rise due to improvements in computed tomography (CT) scanning and increasing use of positron emission tomography scanning and other diagnostic modalities. We report three cases of synchronous double primary lung cancer (DPLC) diagnosed based on CT findings, results of bronchoscopy and histological study. All patients had a long-term history of heavy smoking. Squamous cell carcinoma and small cell carcinoma were the most common histological types in these cases. DPLC frequently involves the upper lobes of left or right lung. Future molecular biological studies on DPLC should be warranted to shed light on the mechanisms underlying the pathogenesis of DPLC and the role of targeted therapy in this condition.     

子宫内膜和卵巢原发性双癌11例临床分析

目的：探讨子宫内膜和卵巢原发性双癌的临床病理特点、治疗及预后。方法：回顾性分析自2001年1月至2009年1月江西省妇幼保健医院肿瘤科收治的11例子宫内膜和卵巢原发性双癌病例资料。结果：11例患者中位年龄50岁,27．3％（3／11）患者未育。阴道出血为主要症状63．6％（7／11）,盆腔包块为主要体征90．9％（10／11）。所有患者均接受手术治疗,术后4例病理报告子宫内膜和卵巢为子宫内膜样腺癌,占36．36％。9例患者术后接受化疗,1例接受放疗。9位患者随访14—61个月,均存活,2例失访。结论：子宫内膜和卵巢原发性双癌较单纯子宫内膜癌或卵巢癌发病年龄早,部分患者有未育史,子宫内膜和卵巢均为子宫内膜样腺癌为最常见病理类型,手术治疗为首选治疗方案,根据患者的身体状况和病理类型辅以放疗和化疗。此病预后良好。     

子宫内膜和卵巢原发性双癌11例临床分析

目的:探讨子宫内膜和卵巢原发性双癌的临床病理特点、治疗及预后.方法: 回顾性分析自2001年1月至2009年1月江西省妇幼保健医院肿瘤科收治的11例子宫内膜和卵巢原发性双癌病例资料.结果: 11例患者中位年龄50岁,27.3%(3/11)患者未育.阴道出血为主要症状63.6%(7/11),盆腔包块为主要体征90.9%(10/11).所有患者均接受手术治疗,术后4 例病理报告子宫内膜和卵巢为子宫内膜样腺癌 ,占36.36%.9例患者术后接受化疗,1例接受放疗.9位患者随访14-61个月,均存活,2例失访.结论: 子宫内膜和卵巢原发性双癌较单纯子宫内膜癌或卵巢癌发病年龄早,部分患者有未育史,子宫内膜和卵巢均为子宫内膜样腺癌为最常见病理类型,手术治疗为首选治疗方案,根据患者的身体状况和病理类型辅以放疗和化疗.此病预后良好.     

31例同期双原发肺癌的手术方式和患者生存情况分析

背景与目的双原发肺癌(doubl eprimary lungcancer,DPLC)的概念已被普遍认可,近年来文献报道同期DPLC的发生率有所增加,然而其诊断标准和治疗原则尚待进一步完善。本文总结同期DPLC的手术方式和患者的生存情况。方法对中国医学科学院中国协和医科大学肿瘤医院胸外科1983年1月至2004年4月手术治疗的同期DPLC的发生情况、手术方式、术后并发症发生情况和患者的生存情况进行分析。结果全组同期DPLC患者共31例,占该时段我科手术治疗原发肺癌患者的0.67%(31/4649)。两个癌灶均行所在肺叶切除或全肺切除者12例,至少有一个病灶行局部切除者19例。术后并发症发生率为29%(9/31),包括呼吸功能不全1例、肺不张3例、房颤2例、反复咯血1例、胸腔积液1例、切口脂肪液化1例,无手术中及手术后30天内死亡。术后1、3、5年生存率分别为52%、29%、20%。结论同期DPLC发病率低,对同期DPLC患者采取积极、合理的手术治疗可以取得满意的疗效;术后并发症发生率低,部分患者可获长期生存。     

Synchronous primary cancers of trachea and esophagus and ventricular tachycardia

The incidence of multiple primary cancers involving trachea is rare. We present a case of synchronous double primary cancer of trachea and esophagus in a 70-year-old woman, with a special symptom of ventricular tachycardia and no/a/story of smoking and alcohol drinking. Biopsies （tom multiple loci demonstrated the patient had primary small cell cancer of trachea and squamous cell carcinoma in situ of esophagus. The patient was successfully treated with four cycles of chemotherapy consisting of etoposide and earboplatin （EC） followed by thoracic radiotherapy （60 Gy in 30 fractions, in 6 weeks）, and was evaluated to have complete response of tumor. To our knowledge, there is no synchronous cancer of trachea and esophagus has been reported in English literature, and our experience showed sequential EC chemotherapy and radiotherapy provided an effective treatment to control both cancers.