论文部分内容阅读
目的探讨年轻妇女子宫内膜癌患者手术保留卵巢的可能性。方法回顾性分析郴州市第一人民医院妇产科1996年1月至2005年12月期间经病理检查确诊的子宫内膜癌患者共189例,对术后病理证实发生卵巢转移病例的可能与子宫内膜癌发生卵巢转移相关的临床病理指标进行分析;另外对手术保留了卵巢的病例进行随访,观察术后有无复发转移,随访时间以月为单位。结果卵巢转移与病灶大小(>2 cm),深肌层浸润,子宫浆膜层受侵犯,非子宫内膜样腺癌的病例类型,低分化的子宫内膜样腺癌,腹水癌细胞阳性有关(P<0.05),与年龄,宫颈受累程度,子宫病灶部位,血CA 125水平无关(P>0.05)。多因素分析结果显示深肌层浸润,非子宫内膜样腺癌,腹水细胞学阳性是发生卵巢转移的独立危险因素。对保留了单侧或双侧卵巢的年轻患者进行随访发现I期高分化的子宫内膜癌患者均无不良预后。结论对于年轻的要求保留卵巢的患者,如果为I期高分化子宫内膜样腺癌,无深肌层浸润,腹水细胞学阴性,有较好的随访条件者可予以保留单侧或双侧卵巢,以提高其生活质量。
Objective To investigate the possibility of ovarian preservation in young women with endometrial cancer during surgery. Methods A retrospective analysis of the First People’s Hospital of Chenzhou City, obstetrics and gynecology from January 1996 to December 2005 by pathological examination confirmed a total of 189 cases of endometrial cancer, postoperative pathology confirmed the occurrence of ovarian metastasis may be associated with the uterus Endometrial cancer ovarian metastasis-related clinical and pathological indicators were analyzed; the other cases of ovarian preservation surgery were followed up to observe whether the recurrence and metastasis after follow-up time in months. Results The ovarian metastasis was related to the size of tumor (> 2 cm), deep myometrial invasion, invasion of uterine serosa, non-endometrioid adenocarcinoma, poorly differentiated endometrioid adenocarcinoma, ascites carcinoma cells (P <0.05), but not with the age, the degree of cervical involvement, the location of uterine lesions and blood CA125 level (P> 0.05). Multivariate analysis showed that deep myometrial invasion, non-endometrioid adenocarcinoma, ascites cytology positive is an independent risk factor for ovarian metastasis. A follow-up of younger patients with retained unilateral or bilateral ovaries showed no adverse prognosis in stage I highly differentiated endometrial cancer. Conclusions For young patients with retained ovaries, patients with well-differentiated endometrioid adenocarcinoma of stage I, with no deep myometrial invasion, negative ascitic cytology, and those with better follow-up conditions, may be given either unilateral or bilateral ovarian To improve their quality of life.