件切除术,术后随访6年,无复发[16]。 6 EUC的预后 主要与分期、浸润肌层深度、有无合并其它恶性成份、治疗方案有关。虽然多 采用综合治疗,但患者多预后差。除Abeler等[2]外,其它学者报道的病例中小 细胞癌Ⅰ期9例,6例随访1年以上,3例2年内复发或转移,1例4年后死亡;Ⅱ期6例 ,其中3例1年内死亡;Ⅲ期10例中随访9例,其中6例半年内死亡;Ⅳ期10例中随访 7例,6例在1年内死亡,1例在2年内死亡[3-15]。Jones等[16]报道的大细胞癌 Ⅰb期和Ⅰb期以上的患者5例,3例在3年内死亡。但Abeler等[2]报道的31例EUC 患者的预后与其它学者的观点相反,其5年生存率为58.1%,10年生存率为48.4%, 其中Ⅰ、Ⅱ期占78%,他认为EUC患者预后并不象其他学者所说的那么差,这可能与 分期早有关。 参 考 文 献 1,连利娟主编.林巧稚妇科肿瘤学.第2版,北京:人民卫生出版社,1996.397 2,Abeler VM,Kjorstad KE,Nesland JM.Undifferentiated carcinoma of the e ndometrium. A histologic and clinical study of 31 cases. Cancer,1991,68 :98 3,Olson N,Twiggs L, Sibley R.Small-cell carcinoma of endometrium:Light microscopicand ultrastructural study of a case. Cancer,1982,50:760 4,Huntsman DG,Clement PB,Blake GC,et al.Small-cell carcinoma of the en dometrium:A clinicopathological study of sixteen cases.Am J Surg Pathol ,1994,18:364-375 5,Bannatyne P,Russell P,Wills EJ.Argyrophilia and endometria carcinoma . Int J Gynecol Pathol,1983;2:235-254. 6,Kumar NB.Small cell carcinoma of the endometrium in a 23-year-old wo men:Light microscopic and ultrastructural study. Am J Clin Path, 1984,8 1:98-101 7,Paz RA,Frigerio B,Sundblad AS,et al.Small-cell(oat-cell)carcinoma of the endometrium.Arch Pathol Lab Med, 1985,109:270-272 8,Kristensen PB,Paulsen SM.Simultaneous presentation of a small-cell c arcinoma involving the ovary and the uterine endometrium.J Submicrosc C yto,1985,17:97-103 9,Tohya T,Miyazaki K, Katabuchi H, et al.Small cell carcinoma of the e ndometrium associated with adenosquamous carcinoma:A light and electron microscopic study.Gynecol Oncol,1986,25:363-371 10,Manivel C,Wick MR, Sibley RK. Neuroendocrine differentiation in Mul lerian neoplasms. An immunohistochemical study of a “pure”endometrial small-cell carcinoma and a mixed Mullerian tumor containing small-cell carcinoma. Am J Clin Pathol,1986,86:438-443 11,Campo E,Brunier MN,Merino MJ.Small cell carcinoma of the endometriu m with associated ocular paraneoplastic syndrome.Cancer,1992,69:2283-22 88 12,Bertarelli C,Cattani MG,Magni E,et al. Carcinoma a piccole cellule del’ endometrio con differenziazione ghiandolare e squamosa.Pathologic al, 1986,78:79-87 13,Tenti P,Carnevali L,Pauli M,et al. Differentiating endometrial aden ocarcinoma. Report of a case. Eur J Gynec Oncol, 1989,10:292-294 14,Hoeven KH,Hudock JA,Woodruff JM,et al. Small cell endocrine carcino ma of the endometrium. Int J Genecol Pathol,1995,14:21-29 15,Crofs JW,Bachyniski BN,Odel JG.Visual paraneoplastic syndrome assoc iated with undifferentiated endometrial carcinoma. Can J Ophthalmol,198 8,23:128-132 16,Jones MA,Young RH,Scully RE. Endometrial adenocarcinoma with a comp onent of giant cell carcinoma. Int J Genecol Pathol,1991,10:260-270 17,Rosai J.Ackerman’s Surgical Pathology, 6th ed.St Louis:CV Mosby CO ,1981,266 18,Azzopardi JG,Muretto P,Goddeeris P,et al. Carcinoid’tumors of the breast:The morphological spectrum of argyrophil carcinoma. Histopatholo gy,1982,6:549-569 19,Eusebi V,Pileri S,Usellinl L,et al. Primary endocrine carcinoma of the parotid salivarygland associated with a lung carcinoid:A possible n ew association.J Clin Pathol,1982,35:611-616
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