子宫内膜样腺癌伴鳞状上皮分化46例临床病理特征及预后分析

目的:探讨子宫内膜样腺癌伴鳞状上皮分化的临床病理特征及预后。方法:回顾性分析46例子宫内膜样腺癌伴鳞状上皮分化患者(观察组)的临床病理特征、治疗情况及预后,并抽取相同时期住院的63例子宫内膜样腺癌患者为对照组,进行分析比较。结果:观察组患者的年龄及临床特征与对照组较一致,两组比较差异无统计学意义(P>0.05)。观察组患者肿瘤高分化比例(30.4%)明显低于对照组(57.1%),差异有统计学意义(P=0.007);肿瘤中分化(41.3%)和低分化(28.3%)比例均高于对照组(30.2%,12.7%),但差异无统计学意义(P>0.05)。观察组与对照组的肿瘤分期、肿瘤细胞浸肌深度、淋巴结转移情况等病理特征比较差异均无统计学意义(P>0.05)。两组治疗方法比较差异无统计学意义(P>0.05)。两组平均随访31.4±17.6个月,观察组死亡及复发共4例(8.7%,4/46),对照组共3例(4.8%,3/63),差异无统计学意义(P>0.05)。结论:子宫内膜样腺癌伴鳞状上皮分化以中低分化为主,但其临床病理特征、预后与普通型子宫内膜样腺癌无明显差别,临床处理与子宫内膜样腺癌一致。

Clinical Pathological Features and Prognosis of Endometrial Adenocarcinoma with Squamous Epithelial Differentiation in 46 Cases

Objective:To explore the clinical pathological features and prognosis of endometrial adenocarcinoma with squamous epithelial differentiation.Methods:The clinical pathological features,treatment conditions and prognosis of 46 endometrial adenocarcinoma with squamous differentiation(study group) in our hospital from June 2005 to December 2010 were retrospectively analyzed.Sixty three cases of endometrial adenocarcinoma(without squamous differentiation) in the same period of time were in the control group.Results:There were no statistical significances of age and clinical features between two groups(P>0.05).The well-differentiated tumors in the study group was significantly higher than that in the control group(P=0.007,30.4% vs 57.1%),while there were no differences between the two groups in the cases with moderate or poor differentiated tumors(P>0.05,41.3% vs 30.2%,28.3% vs 12.7%).And there were no statistical significances of the tumor staging,the myometrial invasion and the status of lymph node metastasis.The mean time of follow up was 31.4±17.6 months in this study.There were 2 cases of recurrence and 2 cases of death in the study group(8.7%,4/46),while 2 cases recurrence and only 1 case of death in the control group(4.8%,3/63).There was no statistical difference between two groups(P>0.05).Conclusions:Endometrial adenocarcinoma with squamous differentiation mainly occurs in the moderate and poor differentiated tumors.However,its clinical treatment and prognosis are the same as endometrial adenocarcinoma.