目的:我们询问为什么子宫内膜癌有时会消失。
方法:在过去5年中,共纳入454例诊断为子宫内膜样型子宫内膜癌(EC)(通过子宫内膜取样)并在我们的诊所接受治疗的患者。患者分为两组:消失和残留,取决于术后子宫切除术标本中是否检测到肿瘤。患者年龄,怀孕和分娩的数量,更年期状态,全身性疾病状态,血象参数,国际妇产科联合会(FIGO)年级,和侵袭状态(在磁共振成像[MRI]上很明显)进行了组间比较。
结果:42例(9.25%)患者的ECs消失。FIGO1级患者的消失率为19.7%(37/187),2级患者为2.1%(5/238),3级患者为0%(0/29)。消失组的平均年龄低于残留组,但绝经前状态和1级肿瘤发生率较高(均p<0.001)。在消失组(p<0.001)中更常见的是没有侵袭(如MRI显示的)。消失组没有复发,但在残留组中,有3.3%(14/412)出现复发.在怀孕或分娩的任何数量上,组间没有显着差异,全身性疾病状态,或血象参数(均p>0.05)。
结论:子宫内膜样1级EC(通过子宫内膜活检显示)的绝经前妇女在MRI上缺乏肌层浸润的可能性更大。
OBJECTIVE: We asked why endometrial cancer sometimes vanishes.
METHODS: A total of 454 patients diagnosed with endometrioid-type endometrial cancer (EC) (via endometrial sampling) and treated in our clinic over the past 5 years were enrolled. The patients were divided into two groups:
vanishing and residual, depending on whether a tumor was detected in the postoperative hysterectomy specimen. Patient age, numbers of pregnancies and deliveries, menopausal status, systemic disease status, hemogram parameters, International Federation of Gynecology and Obstetrics (FIGO) grade, and invasion status (evident on magnetic resonance imaging [MRI]) were compared between the groups.
RESULTS: ECs vanished in 42 (9.25%) patients. The
vanishing rates were 19.7% (37/187) in FIGO grade 1 patients, 2.1% (5/238) in grade 2 patients, and 0% (0/29) in grade 3 patients. The average age was lower in the
vanishing than the residual group, but the premenopausal status and grade 1 tumor rates were higher (both p < 0.001). An absence of invasion (as revealed by MRI) was more common in the
vanishing group (p < 0.001). No recurrence developed in the vanishing group, but recurrences were noted in 3.3% (14/412) of the residual group. There were no significant between-group differences in any of the numbers of pregnancies or births, systemic disease status, or hemogram parameters (all p > 0.05).
CONCLUSIONS: Vanishing EC is more likely in premenopausal women with endometrioid grade 1 EC (as revealed by endometrial biopsy) who lack myometrial invasion on MRI.