子宫癌肉瘤的临床病理分析(1)
[摘要]目的 分析子宫癌肉瘤的临床病理特征及预后情况，为子宫癌肉瘤的临床诊断和治疗提供可靠的参考依据。方法 于2007年1月～2016年3月，选取随访5年成功的60例子宫癌肉瘤患者作为研究对象，回顾性分析患者的临床资料，对子宫肉瘤患者的临床病理特征进行分析，并观察其手术治疗情况和预后情况。根据子宫癌肉瘤患者的死亡情况将其分为存活组、死亡组，对影响子宫癌肉瘤预后的相关因素进行单因素分析和多因素Logistic回归分析。结果 60例子宫癌肉瘤患者的子宫体积均出现异常增大，子宫腔内瘤体呈菜花状或息肉状，瘤体表面存在不同程度的出血和坏死，镜下可见部分子宫癌肉瘤的上皮细胞出现分化，均侵及子宫肌层。随访5年发现，60例患者中有42例患者发生死亡，18例患者成功存活，其5年存活率为30%。单因素分析得出，存活组和死亡组的肿瘤大小、肌层浸润深度、淋巴结转移、肿瘤TNM分期及术后病灶残留存比较，差异有统计学意义(P<0.05)；多因素Logistic回归分析确认，肌层浸润深度、淋巴结转移、肿瘤TNM分期及术后病灶残留是影响子宫癌肉瘤的主要危险因素。结论 子宫癌肉瘤的死亡率较高，其预后受肌层浸润深度、淋巴结转移、肿瘤TNM分期、术后病灶残留的影响，临床上应针对以上影响因素制定更加有针对性的治疗方案，以改善预后。
[关键词]子宫癌肉瘤；临床病理；预后；危险因素
[中图分类号] R737.33 [文献标识码] A [文章编号] 1674-4721(2016)06(c)-0106-04
[Abstract]Objective To analyze the clinical pathological characteristics and prognosis of uterine carcinosarcoma，and to provide reliable reference basis for the clinical diagnosis and treatment for uterine carcinosarcoma.Methods From January 2007 to March 2016，60 uterine carcinosarcoma patients with successful follow-up for 5 years were selected as the research objects.The clinical data of patients were retrospective analyzed.The clinical pathological characteristics of uterine sarcoma patients were analyzed，and the surgical treatment and prognosis were observed.Patients were divided into survival group and death group according to death situation of uterine carcinosarcoma patients.Single factor analysis and multiple factors Logistic regression analysis were used to analyze the related factors that impacted the prognosis of uterine carcinosarcoma.Results The uterine volume of 60 uterine sarcoma patients were abnormal，tumors in uterine cavity showed cauliflower or polypoid，different degrees of hemorrhage and necrosis were present on the surface of the tumors，the epithelial cells of the uterus sarcoma showed differentiation under the microscope and all invaded the uterine muscular layer.5 years follow-up found 42 of the 60 patients died，18 patients survived successfully and the 5 years survival rate was 30%.Single factor analysis showed that the tumor size，depth of muscular invasion，lymph node metastasis，TNM staging of tumor and postoperative residual disease between survival group and death group had obvious difference (P<0.05)；Multiple factors Logistic regression analysis affirmed that depth of muscular invasion，lymph node metastasis，TNM staging of tumor and postoperative residual disease were mainly risk factors that impacted uterine carcinosarcoma.Conclusion The mortality rate of uterine sarcoma is high and the prognosis is affected by depth of muscular invasion，lymph node metastasis，TNM staging of tumor and postoperative residual disease.More targeted treatment for the above influencing factors should be made in clinical to improve the prognosis. (杨艳)
[关键词]子宫癌肉瘤；临床病理；预后；危险因素
[中图分类号] R737.33 [文献标识码] A [文章编号] 1674-4721(2016)06(c)-0106-04
[Abstract]Objective To analyze the clinical pathological characteristics and prognosis of uterine carcinosarcoma，and to provide reliable reference basis for the clinical diagnosis and treatment for uterine carcinosarcoma.Methods From January 2007 to March 2016，60 uterine carcinosarcoma patients with successful follow-up for 5 years were selected as the research objects.The clinical data of patients were retrospective analyzed.The clinical pathological characteristics of uterine sarcoma patients were analyzed，and the surgical treatment and prognosis were observed.Patients were divided into survival group and death group according to death situation of uterine carcinosarcoma patients.Single factor analysis and multiple factors Logistic regression analysis were used to analyze the related factors that impacted the prognosis of uterine carcinosarcoma.Results The uterine volume of 60 uterine sarcoma patients were abnormal，tumors in uterine cavity showed cauliflower or polypoid，different degrees of hemorrhage and necrosis were present on the surface of the tumors，the epithelial cells of the uterus sarcoma showed differentiation under the microscope and all invaded the uterine muscular layer.5 years follow-up found 42 of the 60 patients died，18 patients survived successfully and the 5 years survival rate was 30%.Single factor analysis showed that the tumor size，depth of muscular invasion，lymph node metastasis，TNM staging of tumor and postoperative residual disease between survival group and death group had obvious difference (P<0.05)；Multiple factors Logistic regression analysis affirmed that depth of muscular invasion，lymph node metastasis，TNM staging of tumor and postoperative residual disease were mainly risk factors that impacted uterine carcinosarcoma.Conclusion The mortality rate of uterine sarcoma is high and the prognosis is affected by depth of muscular invasion，lymph node metastasis，TNM staging of tumor and postoperative residual disease.More targeted treatment for the above influencing factors should be made in clinical to improve the prognosis. (杨艳)