本文選題：子宮內(nèi)膜癌　切入點(diǎn)：透明細(xì)胞癌　出處：《蚌埠醫(yī)學(xué)院》2014年碩士論文

【摘要】：子宮內(nèi)膜透明細(xì)胞癌（ECCC）是子宮內(nèi)膜癌的特殊病理類型，其發(fā)病率約占子宮內(nèi)膜惡性腫瘤的2%～4%[3]，五年生存率僅有52%[4]。而且近年來其發(fā)病有增高趨勢[1]。又因ECCC惡性程度高，早期容易發(fā)生遠(yuǎn)處臟器及淋巴結(jié)轉(zhuǎn)移，浸潤轉(zhuǎn)移率明顯高于子宮內(nèi)膜樣腺癌，宮腔內(nèi)病灶的大小不能預(yù)測肌層浸潤深度及有無宮外轉(zhuǎn)移[5]。同時ECCC缺乏有效的診斷治療方法，因此通過閱讀分析文獻(xiàn)資料，，對國內(nèi)外近年有關(guān)子宮內(nèi)膜透明細(xì)胞癌的診斷及治療方面的新理念、新方法進(jìn)行綜述，以促使臨床醫(yī)生加深對ECCC的認(rèn)識，為臨床醫(yī)生提供診治的新思路、更新治療方法。ECCC為苗勒管起源，單純的透明細(xì)胞癌比較少見，常常與其他病理類型混合存在，預(yù)后較差。其病因不明，但與P53突變關(guān)系密切。ECCC臨床診斷方面，目前宮腔鏡下取子宮內(nèi)膜病理檢查被認(rèn)為是診斷金標(biāo)準(zhǔn)。影像學(xué)檢查仍依據(jù)多普勒超聲、CT及MRI檢查。分子生物學(xué)研究表明HNF1β、HE4、CDC25、LICAM、ck7及cyclingE在ECCC中均較高表達(dá)，有望成為ECCC早期診斷的腫瘤標(biāo)志物，但需要更多病例進(jìn)一步證實(shí)。手術(shù)治療是ECCC患者的首選治療。早期患者實(shí)行全面手術(shù)分期是必要的。晚期患者行腫瘤細(xì)胞減滅術(shù)，對期別較晚的ECCC患者介入治療后再手術(shù)可以改善患者預(yù)后。術(shù)后輔助化療和放療能改善預(yù)后。分子靶向藥物對ECCC有一定療效，但尚未廣泛應(yīng)用于臨床，有待進(jìn)一步實(shí)驗研究來證實(shí)其安全性及有效性。
[Abstract]:Endometrial clear cell carcinoma (Ecc) is a special pathological type of endometrial carcinoma. Its incidence is about 2% [3] of endometrial malignant tumors, and the 5-year survival rate is only 52% [4]. Distant organ and lymph node metastasis are easy to occur in early stage, and the rate of invasion and metastasis is obviously higher than that of endometrioid adenocarcinoma. The size of intrauterine lesions can not predict the depth of myometrial invasion and extrauterine metastasis [5]. At the same time, ECCC is lack of effective diagnostic and therapeutic methods. Therefore, through reading and analyzing the literature, this paper summarizes the new ideas and methods of diagnosis and treatment of endometrial clear cell carcinoma at home and abroad in recent years, in order to promote the clinicians to deepen their understanding of ECCC. To provide clinicians with a new way of diagnosis and treatment. ECCC is the origin of Mullerian tube, simple clear cell carcinoma is rare, often mixed with other pathological types, the prognosis is poor, its etiology is unknown. But it is closely related to p53 mutation. ECCC clinical diagnosis, At present, the pathological examination of endometrium under hysteroscopy is considered as the diagnostic gold standard. The imaging examination is still based on Doppler ultrasound CT and MRI. Molecular biology studies show that HNF1 尾 -HE4, CDC25, LICAMAMK7 and cyclingE are both highly expressed in ECCC. It is expected to be a tumor marker for early diagnosis of ECCC, but more cases need to be confirmed. Surgical treatment is the first choice for patients with ECCC. Postoperative adjuvant chemotherapy and radiotherapy can improve the prognosis of patients with ECCC after interventional therapy. Molecular targeting drugs have certain curative effect on ECCC, but they have not been widely used in clinical practice. Further experimental research is needed to prove its safety and effectiveness.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.33

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