| 刘忠宇赵恩锋△ 刘春红李晨星乔江丽.评估宫颈微浸润腺癌不同外科治疗的结果[J].,2012,12(4):674-677 |
| 评估宫颈微浸润腺癌不同外科治疗的结果 |
| Analysis on Outcome of Different Surgery For MicroinvasiveAdenocarcinoma of the Uterine Cervix |
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| DOI： |
| 中文关键词: 宫颈微浸润癌 彻底手术治疗 单纯全子宫切除 |
| 英文关键词: Microinvasive adenocarcinoma of the cervix Radical surgery Simple hysterectomy |
| 基金项目:新疆生产建设兵团重点科技攻关计划社会发展项目（2010GG42） |
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| 中文摘要: |
| 目的：通过大样本的病例回顾，明确宫颈微浸润腺癌需要彻底外科治疗的病变范围。方法：46 例因患宫颈微浸润腺癌（浸润
深度小于或等于5mm）行外科手术治疗的病人，来自中国人民解放军总医院妇产科，同一位病理专家确定组织学类型、肿瘤分级、
浸润深度、肿瘤宽度、有无淋巴管间的浸润、肿瘤边缘状况、宫旁状况以及是否有结节状的转移。病变分级参照FIGO（2009）的标
准。结果：46 例患者按照现行的FIGO 分期标准，34 例ⅠA1 期，12 例ⅠA2 期。治疗方式主要有宫颈锥切、单纯全子宫切除、全子宫
切除加淋巴结清扫、广泛子宫切除加淋巴结清扫。31 例广泛全子宫切除的患者没有发现宫旁浸润。34 例行淋巴结清扫的病人没
有发现淋巴结转移。平均随访80 个月未见复发。结论：关于微浸润腺癌的处理仍旧有争议，相对于微浸润宫颈鳞状细胞癌而言，
传统的治疗宫颈微浸润腺癌彻底外科治疗更多一些。通过本次研究，我们认为宫颈为浸润癌基质浸润深度小于3mm 或者FIGO
IA1 期的患者，简单的全子宫切除足够，不需要淋巴结清扫、广泛的子宫切除和卵巢切除。 |
| 英文摘要: |
| Objective: Determine the Lesions area of microinvasive adenocarcinoma of the uterine cervix which needed radical
hysterectomy with lymphadenectomy through a large cohort study. Methods: Forty-six cases who needed surgery treatment were included
from the People's Liberation Army General Hospital Obstetrics and Gynecology department.( Depth of invasion was less than or equal to
5mm). Histopathology was reviewed by a senior pathologist to confirm histological subtype, grade of tumor, depth of invasion, linear
extent of the tumor, presence of lymphovascular space infiltration, marginal status of the tumor, parametrial involvement, and the
presence of nodal metastasis. Lesion classification was defined according to FIGO (2009) standard. Results: In accordance with the
current FIGO staging, 34 of the 46 patients belonged to stage I A1 and the other 12 patients were classified as stage IA2. Therapy mainly
included cervical conization, simple hysterectomy, radical hysterectomy with lymphadenectomy. No parametrial involvement was noted
in any of the 31 radical hysterectomy patients .34 patients who received lymphadenectomy had no lymph node metastasis.No recurrences
were noted within an average follow-up period of 80 months. Conclusion: The management of microinvasive adenocarcinoma remains
controversial. The traditional radical therapy is used more frequently in treating microinvasive adenocarcinoma than treating
microinvasive squamous cell carcinoma of the cervix. Through this study, we think that a simple hysterectomy is enough for
microinvasive adenocarcinoma with depth of invasion less than or equal to 3mm. Radical surgery (lymphadenectomy, radical
hysterectomy or Ovariectomy) is not necessary. |
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