• 四川大學(xué)華西第二醫(yī)院病理科，四川成都 610041;

目的:總結(jié)分析子宮內(nèi)膜癌臨床特點(diǎn)、治療方法的療效及與各預(yù)后高危因素之間的關(guān)系，以提高臨床診療水平。方法:回顧性分析我院1998年1月～2005年12月收治住院的子宮內(nèi)膜癌患者499例的臨床病理資料，總結(jié)患者的一般情況、臨床特點(diǎn)并進(jìn)行隨訪，分析內(nèi)膜癌高危因素對(duì)預(yù)后的影響。采用壽命表法計(jì)算患者生存率，Wilcoxon (Gehan) 比分法及Cox比例風(fēng)險(xiǎn)模型分析預(yù)后因素。結(jié)果:(1) 手術(shù)－病理分期I、Ⅱ、Ⅲ期患者5年生存率分別為94%、100％、75.3％，IV期患者1年生存率57.1%、2年生存率11.4％。(2) 單因素分析顯示：病理類型、手術(shù)－病理分期、組織學(xué)分級(jí)、肌層浸潤深度、淋巴結(jié)轉(zhuǎn)移和是否行淋巴結(jié)切除術(shù)是影響預(yù)后的高危因素。（3）多因素分析顯示：病理類型、手術(shù)－病理分期、組織學(xué)分級(jí)和肌層浸潤深度是影響患者預(yù)后的獨(dú)立危險(xiǎn)因素。結(jié)論:(1) 對(duì)具有高危因素的患者，如特殊病理類型、手術(shù)－病理分期期別晚、組織學(xué)分級(jí)為G3和深肌層浸潤，應(yīng)輔以術(shù)后治療以提高生存率。(2)分期越晚，生存率越低（P lt;0.05）。

引用本文： 吳秀麗,何英,楊開選. 499例子宮內(nèi)膜癌預(yù)后及隨訪資料分析. 華西醫(yī)學(xué), 2009, 24(6): 1403-1407. doi: 復(fù)制

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4. 彭芝蘭, 劉興會(huì), 張家文,等. 子宮內(nèi)膜癌290例臨床分析與手術(shù)病理分期的比較[J]. 中華婦產(chǎn)科雜志,1997, 32（10）: 597-600..
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8. LURAIN JR, RUMSEY NK, SCHINK JC, et al. Prognostic significance of positive peritoneal cytology in clinical stage I adenocarcinoma of endometrium[J]. Obstet Gynecol, 1989,74:175179..
9. KADAR N, HOMESLEY HD, MALFETANO JH. Positive peritoneal cytology is an adverse factor in endometrial carcinoma only if there is other evidence of extrauterine disease[J]. Gynecol Onkol, 1992,46:145-149.
10. KILGORE LC, PARTRIDGE EE, ALVAREZ RD, et al. Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling[J]. Gynecol Onkol, 1995, 56:29-33..
11. MOHAN DS, SAMUEL MA, SELIM MA, et al. Longterm outcomes of therapeutic pelvic lymphadenectomy for stage I adenocarcinoma[J]. Gynecol Onkol, 1998, 70: 165-171..
12. ALESSANDRO D SANTIN , STEFANIA BELLONE , TIMOTHY J O’BRIEN, et al. Current treatment options for endometrial cancer. Expert Rev[J]. Anticancer Ther, 2004,4 (4) :679689..
13. 曹澤毅. 婦科惡性腫瘤治療中對(duì)淋巴處理的商榷[J]. 中華婦產(chǎn)科學(xué),2004, 39（2）: 135-147..
  1. 1. 曹澤毅主編. 中華婦產(chǎn)科學(xué)[M].北京: 人民衛(wèi)生出版社, 第一版.1999: 1844-1845..
  2. 2. FIGO ( International Federation of Gynecology and Obstetrics ) annual report on the results of treatment in gynecological cancer[J]. Int J Gynaecol Obstet, 2003, 83 Suppl 1: ixxxii, 1-229..
  3. 3. JAIME PART. Prognostic parameters of endometrial carcinoma[J]. Human pathology,2004, 35 (6) : 649-662..
  4. 4. 彭芝蘭, 劉興會(huì), 張家文,等. 子宮內(nèi)膜癌290例臨床分析與手術(shù)病理分期的比較[J]. 中華婦產(chǎn)科雜志,1997, 32（10）: 597-600..
  5. 5. ELTABBAKH G, MOORE A. Survival of women surgical stage Ⅱ endometrial cancer[J]. Gynecol Oncol, 1999, 74: 80-85..
  6. 6. BORONOW RC. Surgical staging of endometrial cancer: Evolution, evaluation, and responsible challenge. A personal perspective[J]. Gynecol Oncol, 1997, 66: 179-189..
  7. 7. CREASMAN WT, DISAIA PJ, BLESSING J, et al. Prognostic significance of peritoneal cytology in patients with endometrial cancer and preliminary data concerning therapy with intraperitoneal radioparmaceuticals[J]. Am J Obstet Gynecol, 1981,141:921-929..
  8. 8. LURAIN JR, RUMSEY NK, SCHINK JC, et al. Prognostic significance of positive peritoneal cytology in clinical stage I adenocarcinoma of endometrium[J]. Obstet Gynecol, 1989,74:175179..
  9. 9. KADAR N, HOMESLEY HD, MALFETANO JH. Positive peritoneal cytology is an adverse factor in endometrial carcinoma only if there is other evidence of extrauterine disease[J]. Gynecol Onkol, 1992,46:145-149.
  10. 10. KILGORE LC, PARTRIDGE EE, ALVAREZ RD, et al. Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling[J]. Gynecol Onkol, 1995, 56:29-33..
  11. 11. MOHAN DS, SAMUEL MA, SELIM MA, et al. Longterm outcomes of therapeutic pelvic lymphadenectomy for stage I adenocarcinoma[J]. Gynecol Onkol, 1998, 70: 165-171..
  12. 12. ALESSANDRO D SANTIN , STEFANIA BELLONE , TIMOTHY J O’BRIEN, et al. Current treatment options for endometrial cancer. Expert Rev[J]. Anticancer Ther, 2004,4 (4) :679689..
  13. 13. 曹澤毅. 婦科惡性腫瘤治療中對(duì)淋巴處理的商榷[J]. 中華婦產(chǎn)科學(xué),2004, 39（2）: 135-147..