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目的 探讨影响早期子宫内膜癌疗效的有关问题。方法 回顾分析 1989年 1月至 1995年 12月我院收治并经手术治疗的临床Ⅰ、Ⅱ期子宫内膜腺癌 14 9例临床及随访资料。结果 临床分期法Ⅰ、Ⅱ期子宫外转移率 15 .4 4%、累积生存率80 .3 5 % ,与手术分期法比较差异显著 (P <0 .0 5 ) (Kaplan -meier) ;手术分期法Ⅰc 期转移、癌亡率在 15 .0 0 % ;腹腔细胞学阳性检出率 12 .2 2 % ,腹腔肿瘤脱落细胞染色体核型分析阳性检出率 2 1.11%。结论 临床分期法难以反映Ⅰ期癌子宫外转移及发生不良预后的原因 ,手术分期法则更具合理性 ;Ⅰc 期应行次广泛子宫根治术加盆腔及腹主动脉旁淋巴清扫 /采样术 ;腹腔细胞学检查对分期、预后估价、指导治疗均具重要意义 ,应作为本病术前的常规检查内容 ,而染色体细胞学则有较好的敏感性 ,临床意义有待研究。
Objective To investigate the related problems affecting the efficacy of early endometrial cancer. Methods The clinical and follow-up data of 149 clinical stage I and II endometrial adenocarcinomas admitted to our hospital from January 1989 to December 1995 were retrospectively analyzed. Results The clinical stage Ⅰ and Ⅱ extra-uterine transfer rate was 15.44%, and the cumulative survival rate was 80.35%, which was significantly different from the surgical staging method (P0.05) (Kaplan-meier) France Ⅰc stage metastasis, the rate of cancer was 15.0%; the positive rate of peritoneal cytology was 12.22%; the positive rate of chromosome karyotype analysis of exfoliated cells was 21.11%. Conclusions The clinical staging method is difficult to reflect the causes of extrauterine metastasis and poor prognosis of stage Ⅰ carcinoma, and the staging method is more reasonable. Stage Ⅰc should be performed with extensive radical hysterectomy plus pelvic and para-aortic lymph node dissection / sampling; The examination of the staging, prognosis and evaluation, guidance and treatment are of great significance, should be used as routine examination of the contents of this disease, while the chromosomal cytology has a good sensitivity, clinical significance remains to be studied.