子宫腺肌病合并子宫内膜癌的临床病理分析

目的 研究子宫腺肌病合并子宫内膜癌患者的临床病理特征,并比较子宫腺肌病合并子宫内膜癌患者与单纯的子宫内膜癌患者的高危影响因素及其对复发与预后意义.方法 对凉山州第二人民医院妇产科2005年2月至2015年7月期间治疗的307例子宫内膜癌患者的临床病理资料进行了回顾性分析,其中子宫腺肌病合并子宫内膜癌患者31例(A组,10.1％),其余276例为单纯的子宫内膜癌患者(B组,89.9％),比较两组患者手术病理分期、病理类型、肌层浸润深度、雌激素受体和孕激素受体的表达、细胞学分型、腹水细胞学、淋巴结转移,复发率、3年无病存活率、3年总存活率等资料.结果 A组相比于B组,其肌层深度浸润较浅、组织分化程度好、PR阳性检测率高、ER阳性检测率高、复发率低、3年无病存活率高、3年总存活率高,差异均具有统计学意义(x2值分别为4.065、6.285、4.480、6.813、4.98、12.45、17.87,均P＜0.05).两组患者手术病理分期、年龄、绝经率、体重指数、腹水细胞学阳性率、淋巴结转移及病理类型比较差异均无统计学意义(x2值分别为1.47、2.31、1.22、1.76、1.21、2.04、2.57,均P＞0.05).结论 子宫腺肌病合并子宫内膜癌可能为雌激素依赖性肿瘤,肌层浸润较浅,组织分化好,相较单纯的性子宫内膜癌患者其高危因素少.患者术后复发率低,3年无病存活率高,3年总存活率高,预后较好.

Clinical and pathological analysis of endometrial carcinoma combined with adenomyosis

Objective To analyze the clinical and pathological characteristics of patients with adenomyosis combined with endometrial carcinoma and compare the high risk factors and their significance for recurrence and prognosis between adenomyosis combined with endometrial carcinoma and pure endometrial carcinoma.Methods The clinical and pathological data of 307 endometrial carcinoma patients hospitalized in the Second People's Hospital of Liangshan City during February 2005 to July 2015 were analyzed retrospectively.Patients were divided into merge adenomyosis with endometrial carcinoma group (10.1％,group A) and pure endometrial carcinoma group (89.9％,group B).The clinical stage,pathological type,depth of myometrial invasion,estrogen receptor (ER) and progesterone receptor expression (PR),cytological typing,ascites cytology,lymph node metastasis,recurrence rate,survival rate without disease for 3 years,overall survival for 3 years between two groups were compared.Results Compared to group B,group A was more superficial in myometrial invasion,better in tissue differentiation,higher in PR tested positive rate,higher in ER tested positive rate lower recurrence rate,higher survival rate without disease for 3 years and higher overall survival rate.The differences were statistically significant (x2 value was 4.065,6.285,4.480,6.813,4.98,12.45 and 17.87,respectively,all P ＜ 0.05).There were no significant differences between two groups in the surgical pathological stage,age,menopause rate,body mass index,positive rate of ascites cytology,lymph node metastasis and pathological type (x2 value was 1.47,2.31,1.22,1.76,1.21,2.04 and 2.57,respectively,all P ＞0.05).Conclusion Adenomyosis combined with endometrial carcinoma mostly belongs to an estrogen-dependent tumor.It is of better differentiated tissue and superficial myometrial invasion.Compared to patients with pure endometrial carcinoma,the patients with adenomyosis combined with endometrial carcinoma are of less high risk factors.After surgery,patients with adenomyosis combined with endometrial carcinoma present low recurrence rate,high survival rate without disease for 3 years,high overall survival rate and good prognosis.