本文選題：子宮內(nèi)膜癌　切入點(diǎn)：復(fù)發(fā)　出處：《中國微創(chuàng)外科雜志》2017年06期 　論文類型：期刊論文

【摘要】：目的總結(jié)子宮內(nèi)膜癌復(fù)發(fā)的臨床特點(diǎn)。方法 2006年1月~2015年12月,我院首次確診為子宮內(nèi)膜癌,臨床資料完整,經(jīng)病理學(xué)診斷確診為子宮內(nèi)膜癌,前次手術(shù)為標(biāo)準(zhǔn)的系統(tǒng)分期手術(shù),接受再次手術(shù)或穿刺病理證實(shí)為子宮內(nèi)膜癌復(fù)發(fā),并進(jìn)行隨訪的患者共22例,對臨床資料進(jìn)行回顧性分析。結(jié)果 22例首次確診內(nèi)膜癌的中位年齡為52歲(44~63歲),絕經(jīng)后陰道出血為子宮內(nèi)膜癌最常見的臨床癥狀(54.5%,12/22)。子宮內(nèi)膜樣腺癌18例(81.8%),漿液性腺癌3例(13.6%),透明細(xì)胞癌1例(4.5%)。子宮肌層受累情況:局限于黏膜內(nèi)0例,肌層浸潤1/2 14例(63.6%),肌層浸潤1/2 7例(31.8%),肌層浸潤達(dá)漿膜層1例(4.5%),穿透漿膜層0例;淋巴結(jié)陽性4例(18.2%),均為盆腔淋巴結(jié),腹主動脈旁淋巴結(jié)均陰性。術(shù)后病理分期FIGOⅠA期12例(54.5%),ⅠB期5例(22.7%),Ⅱ期1例(4.5%),ⅢC_1期4例(18.2%)。中位腫瘤復(fù)發(fā)時間4年(1.5~7年),均無明顯自覺癥狀,血清CA125升高12例(54.5%),超聲或CT發(fā)現(xiàn)局部腫塊9例(40.9%),體檢胸部X線片發(fā)現(xiàn)肺占位1例(4.5%)。盆腔內(nèi)復(fù)發(fā)14例(63.6%),腹膜后髂血管周圍淋巴結(jié)復(fù)發(fā)6例(27.3%),前腹壁腹膜外轉(zhuǎn)移合并肺轉(zhuǎn)移復(fù)發(fā)1例(4.5%),肺轉(zhuǎn)移復(fù)發(fā)1例(4.5%)。3例接受Lynch綜合征篩查,其中2例陽性。結(jié)論子宮內(nèi)膜癌復(fù)發(fā)病例中,腫瘤肌層浸潤較常見,復(fù)發(fā)患者臨床癥狀不明顯,盆腔內(nèi)復(fù)發(fā)為最常見的復(fù)發(fā)部位。
[Abstract]:Objective to summarize the clinical features of recurrence of endometrial carcinoma. Methods from January 2006 to December 2015, our hospital first diagnosed endometrial carcinoma with complete clinical data, and was diagnosed as endometrial carcinoma by pathology. The previous operation was a standard systematic staging operation, and 22 patients were followed up with recurrent endometrial carcinoma confirmed by re-operation or puncture pathology. Results the median age of 22 cases of first diagnosed endometrial carcinoma was 52 years old and 44 / 63 years old. Postmenopausal vaginal hemorrhage was the most common clinical symptom of endometrial carcinoma. There were 3 cases of gonadal carcinoma and 1 case of clear cell carcinoma. The involvement of myometrium was limited to the mucous membrane in 0 cases. There were 1/2 cases of myometrial infiltration in 1/2 cases, 1/2 cases of myometrium infiltration in 1/2 cases, 1 case of myometrium infiltration reaching serous layer in 1 case, and 1 case of penetrating serous layer in 0 cases, and 4 cases of lymph node positive in 4 cases, all of them were pelvic lymph nodes. FIGO stage 鈪，

本文編號：1576343