辅助内分泌治疗对Ⅰ期子宫内膜癌疗效的临床观察

目的 研究辅助内分泌治疗对Ⅰ期子宫内膜癌患者预后的影响. 方法选取1992-01-2002-12 共11年间我院诊治Ⅰ期子宫内膜癌患者105例进行回顾性研究. 结果内分泌治疗组和对照组无瘤生存及总生存情况比较,差异无统计学意义（P=0.2639,P=0.2066）.内分泌治疗＜12个月及对照组的患者复发/转移10例（14.7%）,辅助内分泌治疗≥12个月的患者则为0例,差异有统计学意义（P=0.035）;二者因癌死亡患者分别为8例（11.8%）和0例,差异无统计学意义（P=0.074）;二者无瘤生存及总生存情况的K-M曲线差异均有统计学意义（P=0.0163,P=0.0396）.多因素分析提示肿瘤细胞分化程度、患者年龄及内分泌治疗时间对Ⅰ期子宫内膜癌患者的无瘤生存及总存活率有一定影响. 结论辅助内分泌治疗12个月或以上,可在一定程度上改善Ⅰ期子宫内膜癌患者的预后.

A clinical analysis of the effects of adjuvant endocrine therapy for stage Ⅰ endometrial Carcinoma

Objective To analyze the effects of adjuvant endocrine therapy on the prognosis of stage I endometrial carcinoma. Methods A retrospective study was carried out on 105 cases of stage I endometrial carcinoma who were admitted to our department from Jan.1992 to Dec. 2002. The patients were divided into the endocrine therapy group (54 cases,51.4%) and the control group (51 cases,48.6%). Results The rates of recurrence and metastasis in the endocrine therapy group and the control were 5.6% and 13.7% respectively. And there was no obvious difference on the death from the endometrial carcinoma rate either,which were 3.7% and 11.8% respectively,P=0.274,P=0.153;so did the survival curve of them( P=0.2639,P=0.2066 respectively). The rates of recurrence and metastasis of the control and the patients receiving adjuvant endocrine therapy less than 12 months was 14.7%. But it was zero for the patients receiving adjuvant endocrine therapy reaching to or longer than 12 months. There was statistical difference between them (P=0.035).The patients died from endometrial carcinoma were 8/68 and 0/37,respectively. There was borderline difference statistically (P=0.074). The survival curve of them differed much (P=0.0163,P=0.0396). Multivariate analysis showed that the tumor cell differentiation,age and endocrine therapy duration affected the tumor free survival and total survival of stage I endometrial carcinoma. Conclusions Adjuvant endocrine therapy no less than 12 months may improve the survival of stage I endometrial carcinoma.