子宫内膜癌147例临床分析

目的：探讨子宫内膜癌的治疗及预后相关因素。方法：回顾性分析我科1991～1997年收冶的147例子宫内膜癌患者的临床病理资料，并全部随访。结果：147例患者、平均年龄56．1岁；5年生存率72．8％；临床表现不规则阴道出血135例、盆腔包块81例、白带增多38例及腹痛23例；绝经前病例为39．5％，已占相当比例，有年轻化趋势；临床病理分期愈晚，预后愈差；肌层侵犯的深度与淋巴结转移及病理组织学分级密切相关，深肌层浸润者，易淋巴结转移、病理组织学分级也差；手术为主、放疗、化疗为辅助治疗的综合治疗预后好、并发症少；孕激素对改善预后有一定的价值。结论：以手术为主的综合治疗是目前治疗子宫内膜癌的首选治疗措施；绝经前后的妇女出现不规则阴道出血等非特异性的妇科症状时，必须警惕子宫内膜癌的发生；临床病理分期、肌层浸润深度、病理组织学分级、淋巴结转移情况及孕激素的应用都是影响预后的相关因素。

Clinical Analysis of 147 Cases of Endometrial Carcinoma

Objective:To study the treatment of endometrial carcinoma and analyze the factor of prognosis.Methods:147 cases of endometrial carcinoma admitted in our hospital from 1991 to 1997 were studied retrospectively.Results:The median age was 56.1 years in 147 cases. The overall 5-year survival was 72.8%. The clinical presentations include irregular uterine bleeding 135 cases,pelvec mass 81 cases, leukorrhagia 38 cases and abdomen pain 23 cases, 39.5% of patients were in premenopause. There is a younger trend the depth of muomenopauae patients in surgery stage, but histological grade is significantly worse in postmenopause patients. The depth of myometrial invasion is closely related to lymph node metastasis and histological grade. Surgery stage, histological grade and progestogen therapy imparted better prognosis and less complications.Conclusion:Surgery is the main treatment choice of endometrial carcinoma and radiotherapy and hormone therapy must be adequately used. Perimenopausal women should pay more attention to irregular uterine bleeding to rule out eddometrial cancer. The prognosis is related to stage, histological grade,the depth of myometrial infiltration lymph node metastasis and progestogen therapy.