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子宫内膜癌(endometrial cancer,EC)是女性常见的恶性肿瘤之一,近年发病率有明显上升趋势,因此其诊治理念也不断更新。首先,在临床诊断与分期方面,宫腔镜、超声及腹腔细胞学等检查的意义增加。宫腔镜检查有利于发现微小病灶并定位活检,已成为诊断子宫内膜癌重要手段;超声及腹腔细胞学检查对肿瘤分期及预后判断有较大意义。其次,腹腔镜手术对早期子宫内膜癌治疗显示良好应用前景;放化疗、激素治疗等辅助疗法对中晚期及复发性子宫内膜癌有一定疗效。最后,保留生育功能的观念不断更新。在保证治愈率前提下,尽可能保留女性生育功能已成为妇科肿瘤治疗新理念,反复子宫内膜诊刮及孕激素治疗早期子宫内膜癌已有不少报道。
Endometrial cancer (EC) is one of the most common malignant tumors in women. In recent years, the incidence rate of EC has been on the rise. Therefore, its concept of diagnosis and treatment is continuously updated. First of all, in the clinical diagnosis and staging, hysteroscopy, ultrasound and abdominal cytology and other tests increased significance. Hysteroscopy is helpful to find tiny lesions and locate the biopsy, which has become an important method to diagnose endometrial cancer. Ultrasonography and peritoneal cytology have great significance in staging and prognosis. Second, laparoscopic surgery for early treatment of endometrial cancer has shown good prospects; adjuvant radiotherapy and chemotherapy, hormone therapy and other advanced and recurrent endometrial cancer have a certain effect. Finally, the concept of preserving reproductive function is constantly updated. Under the premise of ensuring the cure rate, as far as possible the retention of female reproductive function has become a new concept of gynecologic oncology treatment, repeated endometrial curettage and progesterone treatment of early endometrial cancer have been reported.