绝经前后妇女子宫内膜癌临床病理分析

【目的】分析未绝经和绝经后妇女子宫内膜癌的临床病理特征。【方法】采用回顾性分析法，将53例内膜癌患者根据绝经与否分为未绝经组34例，绝经组19例，分析比较两组的发病因素、病程、临床表现、病理组织类型及雌、孕激素受体的表达。【结果】未绝经组与绝经组均以不规则阴道流血为主要表现，分别为88．2％、79．0％；未绝经组确诊时间（610．9±145．5）d，显著长于绝经组的（104．1±27．1）d（P〈0．05）；未绝经组子宫内膜样癌占97．1％，显著高于绝经组的78．8％，而非子宫内膜样癌占2．9％，低于绝经组的21．1％（P〈0．05）；两组在肿瘤病理组织学分级均差异无显著性（P〉0．05）；在临床分期间未绝经组Ⅱ期占5．9％，明显低于绝经组的42．1％，而Ⅲ期患者占32．4％，显著高于绝经组的5．3％（P〈0．05）；雌、孕激素受体表达在两组间差异无显著性（P〉0．05）；雌、孕激素受体阳性表达率I期高于Ⅱ～Ⅲ期（P〈0．05）；雌、孕激素受体表达呈正相关关系，雌、孕激素受体与临床分期分别呈负相关关系（P〈0．05）。【结论】子宫内膜癌绝经前、后妇女均以不规则阴道流血为主要的临床表现；I型内膜癌占绝经前、后妇女的绝大多数；雌、孕激素受体可作为内膜癌预后的监测指标；重视绝经前妇女不规则阴道流血是其早期诊断的关键。

Analysis on Clinicopathologic Features in Patients with Endometrial Cancer Before and after Menopause

[Objective]To analyze the clinicopathologic features in patients with endometrial cancer before and after menopause. [Methods]The etiopathogenisis, course, clinical manifestation, pathology, estrogen and progesterone receptor between pre-menopausat group（n =34） and post-menopausal group（n=19） were analyzed and compared retrospectively. [Results]Irregular colporrhagia was the chief appearance in the pre-mena- pausal and post-menapausal groups, and the incidence rate was 88.2 % and 79.9 %, respectively. Final diagnosis time was longer in pre-menopausal group（610.9±145. 5 days） than that in the post-menopausal group （104.1±27.1days）（P〈0.05）. There were 97.1% endometrioid cancer in the pre-menopausal group and 78. 8% endometrioid cancer in the post-menopausal group, and 2.9 % non-endometrioid cancer in the pre-menopa- usal group and 21.1% non-endometrioid cancer in the post-menopausal group. There was no difference in the tumor grades between pre-menopausal group and post-menopausal group（P〉0.05）. There were 5.9% cases with stage Ⅱ and 32.4% with stage Ⅲ in the pre-menopausal group, but there were 42.1% cases with stage Ⅱ and 5.3% cases with stage Ⅲ , and there was significant difference between the two groups（ P〈0.05）. There was no difference in the expression of the estrogen/progesterone receptor between the two groups（P〉0.05）. The expression of estrogen/progesterone receptor in stage I was higher than that in stage Ⅱ and stage Ⅲ（P〈0.05）. There was a positive correlation between estrogen receptor and progesterone receptor（ P 〈0.05）, and a negative correlation between estrogen/progesterone receptor and the operation-pathology stage （P〈0.05）. [Conclusion] Irregular colporrhagia is the chief clinical appearance. Most patients are type I endometrial cancer. Estrogen/progesterone receptor is a good prognostic factor. Paying more attention to irregular colporrhagia in pre-menopausal women is important for early diagnosis.