绝经前后子宫内膜癌临床病理特征差异

【目的】探讨绝经前后子宫内膜癌患者的临床病理特征及诊治的相关因素的差异。【方法】将本院2000～2009年收治确诊为子宫内膜癌的278例患者分为绝经前后两组，分析两组患者的高危因素、临床病理特征。【结果】绝经前后两组患者子宫内膜样腺癌各占96．7％和90．5％，两组T期和Ⅱ期患者各占85％和83．5％，两组差异无显著性（P〉0．05）；两纽比较，绝经前患者组织分级高，G1～2分别为78．3％和61．4％，深肌层浸润分别为1．3％和41．1％，宫颈受累分别为23．4％和11．4％，特殊病理类型分别为3．3％和9．5％。上述各项差异均有显著性（P〈0．5）。【结论】子宫内膜癌发病年龄有年轻化趋势。绝经前妇女一旦出现月经紊乱及其相关的临床表现时，应首先排除子宫内膜癌。绝经前患者病理类型以宫内膜样腺癌为主，肿瘤分化好、肌层浸润的发生率较低，浸润深度较浅，若早期诊治预后较好。

Difference of Clinical and Pathological Characteristics of Endometrial Carcinoma Before and after Menopause

Objective] To explore the difference of clinical and pathological characteristics and related fac tots of the diagnosis and treatment of endometrial carcinoma before and after menopause. Methods] A total of 278 patients diagnosed as endometrial carcinoma in our hospital from 2000 to 2009 were divided into premenopausal group and postmenopausal group. High-risk factors and clinical pathology characteristics in two groups were analyzed. Results] The endometrial adenocarcinoma in two groups accounted for 96. 7%and 90. 5%, respectively, and patients with stage I and patients with stage II accounted for 85 % and 83.5%, respectively, but there was no significant difference between two groups（ P〉0.05）. The premenopansal group has higher tumor grade, and the patients with G1-2 in two groups accounted for 78.3% and 61.40/00, respectively, and deep myometrial invasion for 13. 3% and 41. 1%, respectively, and cervical involvement for 23. 4%and 11.4%, respectively, and special pathology type for 3.3%and 9.5%, respectively, and there were significant differences between two groups（ P〈0.05）. Conclusion] The onset age of endometrial carcinoma tends to be young. For premenopausal women with menstrual disorder or other related symptoms, the endometrial earci noma should be excluded. The pathological type in premenopausal patients is mainly endometrial adenocarcino ma with better differentiation and lower incidence of myometrial invasion, and early diagnosis and treatment for them has favorable prognosis.