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1、分期手術(shù)治療子宮內(nèi)膜癌214例作者：作者：吳玉梅徐曉紅張鐵娟鄧小虹【關(guān)鍵詞】子宮內(nèi)膜癌Stagingoperationintreatmentof214patientswithendometrialcarcinoma[Abstract】AIM:Toevaluatethestagingoperationinthetreatmentofendometrialcarcinoma.METHODS:From1990to2002,214patientswithendometrialcarcinomaincli
2、nicalstageIweretreatedwithstagingoperation(SOgroup,n二134)andtotalhysterectomyplusbilateralsalpingoophorectomy(HBSOgroup,n=80)respectivelyinourhospita1.Theirclinicopathologicaldatawereanalyzedretrospectively.RESULTS:①The5yearsurvivalratewas86.1%inHBSO
3、groupand84.7%inSOgroup?Nosignificantdifferencewasfoundbetweenthetwogroups(P>0.05).ComparedwiththeSOgroup,HBSOgroupwasofsignificantlylesscomplications(P&It;0.05).②Amongthe12recurrencecases,therewere7casesofdistantmetastasisand5casesoflocalrecurrence?T
4、herecurrenceandmetastasiswererelatedwiththeoperationtype?ThelocalrecurrencerateinHBSOgroupwassignificantlyhigherthanthatofSOgroup(P&It;0?01)?③The5yearsurvivalrateofthecaseswithlymphnodemetastasiswassignificantlylower(42.3%)thanthatofoneswithoutmetast
5、asis(75.5%)(P&It;0.01).Thelymphnodemetastasisratewasrelatedtocervicalinvolvement,myometrialinvasion>1/2,specialpathologictypeandhistologicallowdifferentiation(G3)significantly.CONCLUSION:LymphadenectomyforclinicalstageIendometrialcarcinomaresultsinmo
6、reoperationcomplications,butcan?tincreasesurvivalratesignificaritly.LymphadenectomyissuitableforclinicalstageIcaseswithhighriskfactors?Radiotherapyandchemotherapyarenecessaryforcaseswith1ymphnodemetastasis?[Keywords】endometrialneoplasms:operation;tre
7、atmentoutcome;prognosis【摘要】目的：探討分期手術(shù)治療子宮內(nèi)膜癌的臨床價(jià)值.方法：回顧性分析1990/2002分期手術(shù)(S0組,n=134)和全子宮加雙附件切除術(shù)(HBSO組,n=80)治療的214例臨床I期子宮內(nèi)膜癌的臨床病理資料.結(jié)果：①臨床I期的HBSO組與S0組5a生存率分別為86.1%及84.7%,兩組無顯著性差異(P>0.05).兩種術(shù)式比較，HBS0組明顯比S0組的手術(shù)并發(fā)癥少(P<O.05).②12例復(fù)發(fā)病例中7例遠(yuǎn)處轉(zhuǎn)移，5例為盆腔復(fù)發(fā).轉(zhuǎn)移、復(fù)發(fā)與
8、術(shù)式有關(guān)，其中HBSO組局部復(fù)發(fā)率極明顯高于S0組(P<0.01).③淋巴結(jié)轉(zhuǎn)移者的5a生存率42.3%,極明顯低于無轉(zhuǎn)移者的75.5%(P<0.01)?淋巴結(jié)轉(zhuǎn)移率與宮頸受侵、肌侵>1/2、特殊病理類型、組織低分化(G3)顯著相關(guān).結(jié)論：臨床I期子宮內(nèi)膜癌常規(guī)行淋巴清掃術(shù)，并發(fā)癥增加，不能顯著提高生存率.淋巴結(jié)清掃術(shù)對(duì)具有高危因素者是必要的.對(duì)淋巴結(jié)轉(zhuǎn)移者宜術(shù)后行放療和化療.【關(guān)鍵詞】子宮內(nèi)膜癌；手術(shù)；治療結(jié)果；預(yù)后0引言子宮內(nèi)膜癌的手術(shù)病理分期中規(guī)定腹腔細(xì)胞學(xué)檢查、盆腔及腹主動(dòng)脈
