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[目的]了解影响子宫内膜腺鳞癌预后的相关因素。[方法]中山大学肿瘤医院在1980年1月到1999年12月共收治子宫内膜腺鳞癌104例 ,其中78例采用手术或以手术为主的综合治疗 ,本文对其临床病理资料进行了回顾性分析。[结果]按FIGO1988年分期Ⅰ期22例、Ⅱ期17例、Ⅲ期30例、Ⅳ期9例 ,中位随访时间43.7个月(1～216个月) ,总的5年生存率61.1 % ,Ⅰ、Ⅱ、Ⅲ、Ⅳ期的5年生存率分别为93.1%、87.2%、35.8 %、0,病理分级G1、G2 、G35年生存率100%、73.0%、34.1% (P=0.0003) ,病灶侵及子宫内膜、浅肌层、深肌层者的5年生存率分别为100 %、100 %、41.8% (P=0.0000)。COX模型逐步回归结果表明手术病理分期、肿瘤分化程度、浸润深度是预后的危险因素。[结论]子宫内膜腺鳞癌总的预后较典型内膜腺癌差 ;但其早期患者5年生存率并不低 ,可见早期诊断的重要性 ;手术病理分期、肿瘤的分化程度及浸润深度是预后的主要影响因素 ;动脉化疗加全身化疗有利于改善晚期患者的预后 ,其确切意义有待进一步研究
[Objective] To understand the related factors that affect the prognosis of endometrial adenosquamous carcinoma. [Methods] Tumor Hospital of Sun Yat-sen University from January 1980 to December 1999 were treated 104 cases of endometrial adenosquamous carcinoma, of which 78 cases were treated by surgery or surgery-based comprehensive treatment of the clinical and pathological data were carried out Retrospective analysis. [Results] According to FigureO, there were 22 cases of stage Ⅰ, 17 cases of stage Ⅱ, 30 cases of stage Ⅲ and 9 cases of stage Ⅳ. The median follow-up time was 43.7 months (range 1 to 216 months) and the overall 5-year survival rate was 61.1% The 5-year survival rates of stage Ⅰ, Ⅱ, Ⅲ and Ⅳ were 93.1%, 87.2%, 35.8%, 0 respectively. The survival rates of G1, G2 and G35 were 100%, 73.0% and 34.1% The 5-year survival rates of patients with lesions invading the endometrium, superficial myometrium and deep myometrium were 100%, 100% and 41.8%, respectively (P = 0.0000). The stepwise regression of COX model showed that the pathological stage, degree of tumor differentiation and depth of invasion were the risk factors of prognosis. [Conclusion] The overall prognosis of endometrial adenosquamous carcinoma is worse than that of typical endometrial adenocarcinoma. However, the 5-year survival rate of early stage adenocarcinoma of the endometrium is not low, which shows the importance of early diagnosis. The pathological stage, degree of tumor differentiation and depth of invasion Is the main prognostic factor; arterial chemotherapy plus systemic chemotherapy is conducive to improving the prognosis of patients with advanced, its exact significance needs further study