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目的 总结 45岁以下子宫内膜癌患者的临床特点。方法 回顾性分析北京协和医院52例 45岁以下子宫内膜癌患者的临床资料 ,并将其分为≤ 3 5岁年龄组 (A组 ,17例 )与 3 5～ 45岁年龄组 (B组 ,3 5例 )进行比较分析。结果 45岁以下内膜癌患者占内膜癌总数的 12 7% ,随年龄的增加 ,发病人数有增加的趋势 ,约 50 %的患者合并未产、不育、月经失调、子宫内膜增生 ,2 9%合并肥胖 ,2 3 %合并多囊卵巢 ,其中A组合并多囊卵巢的比例为 53 % ,合并内膜不典型增生的比例为 59% ,较B组明显增高 (分别为 9%、2 6% ) ,差异有显著性 (P <0 0 5)。按国际妇产科联盟 (FIGO)标准手术病理分期Ⅰ期占 82 % ,其中A组均为Ⅰ期子宫内膜样腺癌 ;B组有高危因素的患者比例占 2 6% ,但除了分期有升高的趋势 (P <0 0 5)外 ,其余差异均无显著性 (P >0 0 5)。治疗以手术为主 ,另有 2例患者采用孕激素治疗保留生育功能 ,获得缓解。 2例复发。结论 45岁以下子宫内膜癌患者多合并不育、月经失调、内膜增生、肥胖、多囊卵巢 ,表明其发生与雌激素有关 ;期别以Ⅰ期为主 ,尤其是≤ 3 5岁者 ,高危因素少 ,预后较好。对于早期 (Ⅰa期 ) 45岁以下内膜癌患者可考虑保留生育功能或卵巢
Objective To summarize the clinical features of patients with endometrial cancer under 45 years of age. Methods The clinical data of 52 patients with endometrial carcinoma under 45 years of age at Peking Union Medical College Hospital were analyzed retrospectively and divided into groups ≤35 years old (group A, n = 17) and age group 35 ~ 45 (group B , 35 cases) for comparative analysis. Results Endometrial cancer patients under 45 years of age accounted for 12 7% of the total number of endometrial cancer, with increasing age, the incidence of the trend has increased, about 50% of patients with unexplained, infertility, menstrual disorders, endometrial hyperplasia, 29% with obesity and 23% with polycystic ovary. The proportion of combined polycystic ovary in group A was 53%, and the percentage of atypical hyperplasia was 59% in group A, which was significantly higher than that in group B (9% 2 6%), the difference was significant (P <0 05). According to the International Union of Gynecology and Obstetrics (FIGO) standard surgical staging Ⅰ accounted for 82%, of which A group were stage Ⅰ endometrioid adenocarcinoma; B group of patients with risk factors accounted for 26%, but in addition to staging (P <0 05), the other differences were not significant (P> 0.05). Surgery-based treatment, and another two patients with progesterone treatment to retain reproductive function, remission. 2 cases of recurrence. Conclusion 45 cases of endometrial cancer patients with multiple combined infertility, menstrual disorders, endometrial hyperplasia, obesity, polycystic ovary, indicating that its occurrence and estrogen-related period; stage Ⅰ, especially in patients ≤ 35 years , Less risk factors, the prognosis is good. For early (Ⅰ a) endometrial cancer patients under the age of 45 may consider retaining fertility or ovarian