mutrasubi: Clinical Analysis of823Cases of Endometrial Cancer Archive ...

[Abstract]

Objective: to endometrial carcinoma is common gynecologic malignant tumor, inrecent years the incidence rate increased year by year, with younger trend, the purpose ofthis study is based on the domestic and foreign endometrial cancer diagnosis and treatment,and other aspects of the new progress, and reference the specific circumstances, discussionof the new trend, we can realize the diagnosis and treatment of gap at home and abroad, toimprove the ability of diagnosis and treatment and reduce complications and provide thebasis.Methods: The2001.1-2010.12jilin university hospital maternity823were the secondexample palace membrane cancer patients the clinical data were retrospectively analyzed.The general situation of patients, medical history, auxiliary examination results, treatment,and pathological material of screening, record and the establishment of database. SPSS17.0application software for the statistics. Count data to rate said, using the chi-square test. P <0.05as a significant difference between the judgment standard.Results:1. The number of cases is increased year by year trend, a town in patients thanincreasing trend. Endometrial cancer patients, with an average age of53.11+/-9.68yearsold, the age distribution for53~56years old peak. Postmenopausal women, before and afterthe proportion (36.57%,63.43%).2. With high blood pressure, obesity, diabetes, uterine fibroids, uterus XianJiZheng,primary infertility, polycystic ovary syndrome proportion of patients is increasing year byyear (P <0.05), average postmenopausal age of49.19years.3. Total misdiagnosis in7patients, patients were for premenopausal women,preoperative diagnosis are: the uterine fibroids, uterine XianJiZheng, endometrial polyps,submucosal fibroids; The misdiagnosis of17cases, accounting for2.07%of the total, thetentative preoperative diagnosis: cervical cancer.4. Preoperative diagnosis of pathology and scrape obtained than postoperativepathologic, pathological types of accuracy is better, for85.73%, organization the accuracy ofdifferentiation degree average, at66.91%. Vaginal ultrasonic sensitivity is better, for83.48%.To judge received lesions range muscular layer infiltration degree, and the results showed that the correlation between fair (related analysis showed that the relevant columnconnection number=0.597P <0.001Pearson ?s R=0.537P <0.001kappa=0.483P <0.001), whether to discuss the muscular layer invade embellish, no deep muscularis invade,whether of cervical involvement embellish sensitivity, specificity and accuracy are:56.6%,83.77%,75.54%;66.1%,94.42%and88.32%;44.00%,96.77%and91.94%, with lesionssize on received the accuracy of the muscular layer judge compatible, but sensitivity is bad,especially deep muscularis judgment. But for cervical invade the judgment of embellish isaccuracy.5. Preoperative fluid and cell positive rate was7.34%; One CA125positive rate was4.69%, CA125quartile100U/ml5cases were the III-stage IV.6. Open surgery in800(97.72%) patients; Laparoscopic surgery12(1.46%) cases). Yintype operation11(1.34%) were. Laparoscopic surgery and Yin type operation number isrising year by year.7. The operation scope(1) all the clinical stages GongQieChu range still with extensive neutron hysterectomyprimarily. In the I midterm accounted for56.06%; The ratio in II64.52%, all the uterus+double accessories resection in167cases, of which90.77%is extrafascial hysterectomy.(2) The pelvic lymph node dissections in622cases, postoperative36cases havemetastatic cancer, lymph nodes positive rate was5.79%, the number of lymph nodesdetected an average of10to22. At the same time line the abdominal aorta lymph nodedissection of the52cases,3cases had metastatic cancer, lymph node metastasis of positive5.7%. The average number of lymph node detection for:1~3. Preoperative clinical stage Ido pelvic lymph node dissections in543cases, positive nodes for positive rate:3.50%. Age<60years old, staging G1, muscle layer infiltration <1/2, endometrial adenocarcinoma ofthe sample of the clinical stage I endometrial carcinoma patients pelvic lymph nodemetastasis rate is only0.02%.(3) keep ovarian surgery for97(11.79%) patients, all for patients with stage I, the ageof patients in the17~45years old between, with an average age of31to35years. In A, B,C each group has increased year by year (P <0.05).8. Intraoperatie fast pathologic judge the sensitivity of the muscular layer assaultembellish, specificity, accuracy were79.23%,90.91%,82.18%; No deep muscularis invadethe sensitivity, specificity, embellish accuracy were60.00%,97.22%,90.80%.9. Endometrial glands sample783cases (90.11%). The endometrial cancer samples75 cases (9.89%).(1) the endometrial carcinoma in sample postmenopausal group proportion ofpostmenopausal group than not. The endometrial adenocarcinoma of the kind ofdifferentiation medium, low proportion of higher than the endometrial cancer samples, theendometrial carcinoma in sample ?/? period was significantly higher than the proportionof I/phase II, the chi-square test are significant difference (P <0.05).(2) muscle layer infiltration in than1/2, the composition of the G1than high, and thefrequency of muscular layer invade in1/2embellish,> the G1component ratio is high, andthe chi-square test significant difference (P <0.05).10. Occurred after anemia or anemia increase in217(26.37%) were; Postoperativeinfection in92(11.18%) cases, respiratory system symptom for45patients, urinary tractsymptoms for14cases, poor healing incision23cases,5underwent minus a suture art;Occurred after lymphocele46(5.58%) cases,32cases with conservative treatment to absorb,4cases puncture pumping art; Postoperative obstruction9(10.94%) were, both byconservative treatment cured. Thrombotic disease6(0.72%) cases, turn to the relevantdepartments to improve after all, ureteral fistula in3(0.36%) cases, both by the improvedafter surgery; Respiratory failure occurred3(0.36%) patients,2cases better;1(0.12%) casesof bowel perforation, line operatie repair.823examples within the film cancer patients,322cases were followed up rate was39.13%.Conclusion1, the number increased year by year, there is a trend of getting, a town than patientsincreases year by year.2, combined with high blood pressure, obesity, diabetes, primary infertility, uterinefibroids, uterus XianJiZheng, polycystic ovary syndrome of endometrial carcinoma patientsincreased year after year; Have delayed menopause phenomenon. To high-risk groups shouldbe positive for the disease, the Suggestions do regular physical examination.3, premenopausal patients especially the menopausal transition patients, if haveirregular vaginal bleeding, menstrual disorders, by volume and increase of clinicalmanifestations, should be alert to the possibility of endometrial cancer, to reducingmisdiagnosis and misdiagnosed cases.4, preoperative diagnosis should be hysteroscopy, ultrasonic, scraping, combined withthe advantages of each, in order to improve the accuracy of the early diagnosis, I branch should strengthen the CT and MRI of preoperative diagnosis in the application.5, liquid and positive of cytologic examination is relatively low; Serum CA125toendometrial cancer early lack of sensitivity, but cases of late have a certain reference value.6, I branch in species, minimally invasive surgery in surgical trend, basic can keep upwith the domestic and foreign development trend, all have to try, but tend to be conservative.7, for I/phase II patients, shall be properly narrow hysterectomy scope; I endometrialcancer patients <60years old age, organization differentiation G1, endometrialadenocarcinoma, sample muscular layer infiltration <1/2of the pelvic lymph nodemetastasis rate is only0.02%, but no lymph node dissections, invaded the muscular layer ofuncertainty embellish patients can be bank was fast pathologic. Keep the feasibility ofovarian surgery needs further research.8, fast pathologic muscular layer to invade the accuracy of embellish judge higher, ondeep muscularis invade the judgment of embellish sensitivity is lower, but specific good, canbe used as a kind of testing tools.9, the endometrial cancer samples for postmenopausal women, the organizationdifferentiation is poor, the clinical stage late; Organization of the pathology of poorlydifferentiated more prone to deep muscularis assault embellish. Should strengthen theendometrial adenocarcinoma of the kind of importance in the early diagnosis and treatment,to guide clinical prognostic and treatment of some significance.10, incidence rate of postoperative complications were all low level, and has no specialcomplications; Follow-up rate is low, no established disease diagnosis and treatment to crossover files, difficult to statistical5-year survival rate.

Title: Clinical Analysis of823Cases of Endometrial Cancer

Category: Ovarian Cancer

Filename: Clinical Analysis of823Cases of Endometrial Cancer.pdf

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