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目的分析子宫峡部内膜癌的临床病理特点及预后相关因素。方法对天津医科大学总医院1980年1月至2005年12月收治的349例子宫内膜癌,按肿瘤部位分为峡部内膜癌(UIE)组与非峡部内膜癌组,比较两组临床病理特征及预后。结果UIE占10.0%(35/349)。与非峡部内膜癌相比,UIE组阴道排液及腹痛的比例较高(P<0.05)。UIE组更容易发生深肌层浸润、宫颈侵犯、脉管浸润、浆膜受累、腹腔细胞学阳性以及盆/腹腔淋巴结转移,临床分期、手术病理分期较高(P均<0.05),具有较低的5年生存率(P<0.05)。多因素分析显示峡部癌灶并非是预后不良的独立性相关因素。结论子宫峡部内膜癌具有特殊的临床病理特征,其可增强其他预后不良因素的作用而影响预后。
Objective To analyze the clinicopathological features and prognostic factors of endometrial carcinoma of the isthmus. Methods A total of 349 cases of endometrial cancer who were treated in Tianjin Medical University General Hospital from January 1980 to December 2005 were divided into isthmic endometrial carcinoma (UIE) group and non-isthmus endometrial carcinoma group by tumor site. Pathological features and prognosis. Results UIE accounted for 10.0% (35/349). Compared with non-isthmus endometrial carcinoma, the proportion of vaginal discharge and abdominal pain in UIE group was higher (P <0.05). UIE group was more likely to have deep myometrial invasion, cervical invasion, vascular invasion, serosa involvement, positive peritoneal cytology and pelvic / abdominal lymph node metastasis, clinical stage and surgical pathology stage (P <0.05) 5-year survival rate (P <0.05). Multivariate analysis showed that isthmic foci were not associated with poor prognostic independence. Conclusions Endometrial carcinoma of the uterus isthmus has special clinicopathological features, which can enhance the prognosis of patients with other prognostic factors.