子宫颈癌放射治疗后发生子宫内膜癌的临床观察

目的了解宫颈癌放射治疗（放疗）后发生子宫内膜癌的临床特点。方法对２７例宫颈癌放疗后发生的子宫内膜癌的临床资料及雌激素受体（ＥＲ）、孕激素受体（ＰＲ）状态进行回顾性研究。结果宫颈癌放疗后子宫内膜癌的发生率为０．１９％。发病年龄平均为６３岁;接受放疗至确诊子宫内膜癌的时间平均为１５．６年;晚期患者占５１．９％,较一般子宫内膜癌明显高。ＥＲ、ＰＲ的表达率低,仅为１１．８％（２／１７）。５例Ｉ期子宫内膜癌均发生于接受放射剂量较低的宫角及宫底部。２７例中,１９例接受手术治疗,３年、５年的生存率仅为５６．８％及３７．８％。结论盆腔放疗后子宫内膜癌的发生率较其自然发生率为高,晚期患者比例大,ＥＲ、ＰＲ表达率低,治疗应以手术为主,预后较一般子宫内膜癌差

The clinical evaluation of endometrial carcinoma following irradiation for cervical cancer

OBJECTIVE: To study the characteristics and clinical features of endometrial carcinoma occurred after pelvic irradiation. METHODS: Clinical data of 27 cases of endometrial carcinoma occurred after irradiation for cervical cancer were reviewed, estrogen receptor (ER) and progesterone receptor (PR) status were studied in 17 cases by immunohistochemistry. RESULTS: The incidence of endometrial carcinoma occurred following pelvic irradiation was 0.19%. The mean age of patients was 63 year old. The mean incubation period from pelvic irradiation to diagnosis of the disease was 15.6 years. The proportion of advanced cases was 51.9% (14/27). The expression of ER and PR was very low (11.8%, 2/17). The original sites of 5 cases with stage I were in fundus or corner of the uterus, which received lower dose irradiation formerly. Operation was the best choice of treatment, 19 out of 27 cases received this modality. The survival rate of 3 and 5 year was 56.8%, 37.8%, respectively. CONCLUSION: The incidence of endometrial carcinoma occurred following pelvic irradiation for cervical cancer was higher than that of cancer occurred spontaneously, the proportion of advanced cases was high, the expression of ER and PR was very low, operation was the mainly method of treatment. The prognosis was poorer than that of spontaneous disease.