年轻妇女子宫内膜癌53例临床分析

目的探讨45岁以下子宫内膜癌患者的临床特点。方法回顾性分析广东省人民医院53例45岁以下子宫内膜癌患者的临床资料，并将其分为≤40岁年龄组（A组，28例）和40-45岁年龄组（B组，25例）进行比较分析。结果A组57．1％（16，28）的患者合并不孕未产，78．5％（22／28）的患者合并月经不调；B组28．0％（7／25）的患者合并不孕未产，48％（12／25）的患者合并肥胖，56％（14／25）的患者合并异常阴道出血，32％（8／25）的患者合并糖尿病和高血压。A组合并不孕未产的发生率显著高于B组（P〈0．05），两组的孕次和产次也有显著性差异（P〈0．05），两组合并肥胖、高血压、糖尿病的发生率有显著性差异（P〈0．05）。在病理类型、病理分化程度、病理分期、肌层浸润深度、宫颈浸润情况等方面，两组差异无显著性（P〉0．05）。53例均行手术治疗。术后随访2年，B组1例复发。结论40岁以下子宫内膜癌患者多合并不育，40岁以上患者多合并肥胖、糖尿病、高血压等高危因素；其主要临床症状均表现为月经紊乱；45岁以下的子宫内膜癌在病理分化、病理分期、病理类型上等方面无显著差异。通过早期诊断和早治疗可取得良好预后。

Endometrial carcinoma in patients below 45 years of age: clinical analysis of 53 cases

OBJECTIVE: To investigate the clinical characteristics of endometrial carcinoma in patients below 45 years of age. METHODS: The clinical data were collected from 53 patients with endometrial carcinoma below 45 years of age, who were divided into less than 40 year group (group A, 28 cases) and 40 to 45 year group (group B, 25 cases) and their clinical data were compared. RESULTS: A rate of 57.1% (16/28) of the patients in group A were infertile, and 78.5% (22/28) reported irregular menstruation. In group B, the infertility rate was 28.0% (7/25), and 48% (12/25) of the patients were obese, 56% (14/25) had abnormal vaginal bleeding, and 32% (8/25) had diabetes and hypertension. The two groups differed significantly in the infertility rate, number of pregnancies and deliveries and the incidences of obesity, hypertension and diabetes. The pathological classification, grade of differentiation, pathological staging, depth of myometrial invasion, and cervical infiltration status were comparable between the two groups (P>0.05). All the 53 patients received surgical interventions and follow. up for two years, during which 1 patients in group B had relapse. CONCLUSION: Patients with endometrial carcinoma at 40 years of age or below often have infertility, and those over 40 years are exposed to such high-risk factors as obesity, diabetes, and hypertension. Its major clinical symptom of endometrial carcinoma is menstrual disorders. The differentiation, pathological staging, pathological classification of the malignancy are not associated with age in patients below 45 years of age. Early diagnosis often warrants more favorable prognosis.