论文部分内容阅读
近年研究表明,子宫体浆液性乳头状癌(UPSC)与普通的内膜样腺癌在生物学行为和临床表现上均存在差异。多数报道认为Ⅳ期UPSC的5年生存率仅为0～5％。为明确细胞减灭术和其他预后决定因素对Ⅳ期UPSC生存率的影响进行回顾性研究。对象为Johns Hopkins医学机构和Massachusetts总医院于1989年1月1日～1998年12月31日间收治的接受首次手术的UPSC病例。病理为经专家证实的单纯性浆液性癌和浆液性癌合并其他组织亚型(≥25％为浆液性癌)。肿瘤含有肉瘤成分或接受术前放疗者予以剔除。31例被证实为FIGO分期Ⅳ期的UPSC,中位年龄为65(36～84)岁。30例诊治时已绝经,仅2例曾接受激素替代治疗。最常见的症状是子宫异常出血或绝经后出血,占64.5％。其次为进行性腹胀(29.0％),腹盆腔肿块(22.6％),腹痛(9.7％),气
In recent years, studies have shown that uterine body serous papillary carcinoma (UPSC) and ordinary endometrial adenocarcinoma in biological behavior and clinical manifestations are different. Most reports suggest that the 5-year survival rate of stage IV UPSC is only 0 to 5%. To clarify the cytoreductive surgery and other prognostic factors on the survival rate of IV UPSC were retrospectively studied. The subjects were UPSC cases undergoing initial surgery between January 1, 1989 and December 31, 1998 at the Johns Hopkins Medical Institution and the Massachusetts General Hospital. Pathology was confirmed by the experts of pure serous carcinoma and serous carcinoma combined with other tissue subtypes (≥ 25% of serous carcinoma). Tumors containing sarcoma or receiving preoperative radiotherapy were excluded. 31 cases were confirmed as FIGO stage Ⅳ UPSC, the median age of 65 (36 to 84) years old. 30 cases had menopause at diagnosis and treatment, only 2 cases had received hormone replacement therapy. The most common symptoms are abnormal uterine bleeding or postmenopausal bleeding, accounting for 64.5%. Followed by progressive bloating (29.0%), abdominal pelvic mass (22.6%), abdominal pain (9.7%), gas