Hachisuga T, Fukuda K, Iwasaka T, Hirakawa T, Kawarabayashi T, Tsuneyoshi M
Department of Obstetrics and Gynecology, School of Medicine, Fukuoka University, Fukuoka, Japan.
Cancer. 2001 Nov 15;92(10):2578-84. doi: 10.1002/1097-0142(20011115)92:10<2578::aid-cncr1610>3.0.co;2-v.
This study used the clinicopathologic profiles of Japanese women younger than 50 years of age with endometrial carcinoma to distinguish the clinicopathologic features of carcinomas of the lower uterine segment (LUS) from those of carcinomas of the corpus mucosa proper (CMP).
Eighty-eight endometrial carcinomas in women younger than 50 years old (25.3%) were selected from our file of 348 Japanese women with endometrial carcinoma. Seventy-two were classified as carcinomas of the CMP and 16 carcinomas of the LUS. A tumor was judged to be a carcinoma of the LUS when it involved a continuous area ranging from the lower corpus to the upper cervix with or without intervention of a portion of uninvolved LUS.
The mean ages of women with carcinomas of the CMP and LUS were 41.2 and 39.0 years, respectively. In comparison to carcinomas of the LUS, carcinomas of the CMP were more strongly associated with reproductive risk factors including parity (P = 0.01) and polycystic ovary syndrome (P = 0.02). There was no significant difference in body mass index or the incidence of diabetes mellitus and hypertension between women presenting with carcinomas of the CMP and LUS. Histologically, carcinomas of the LUS more frequently showed a high-grade endometrioid tumor (P = 0.02) with deep myometrial invasion (P < 0.01) and were less associated with endometrial hyperplasia (P < 0.01) than those of the CMP.
Carcinomas of the LUS occurred predominantly in women younger than 50 years of age and had clinicopathologic features distinct from carcinomas of the CMP in women younger than 50 years of age.
本研究利用50岁以下日本子宫内膜癌女性的临床病理特征，以区分子宫下段癌（LUS）与子宫体部黏膜癌（CMP）的临床病理特征。
从我们收集的348例日本子宫内膜癌女性病例中，选取88例50岁以下的子宫内膜癌患者（占25.3%）。其中72例归类为CMP癌，16例为LUS癌。当肿瘤累及从子宫体下段至子宫颈上段的连续区域，无论是否存在未受累的子宫下段部分时，则判定为LUS癌。
CMP癌和LUS癌女性的平均年龄分别为41.2岁和39.0岁。与LUS癌相比，CMP癌与生殖风险因素的关联更为密切，包括产次（P = 0.01）和多囊卵巢综合征（P = 0.02）。CMP癌和LUS癌女性的体重指数、糖尿病和高血压发病率无显著差异。组织学上，LUS癌更常表现为高级别子宫内膜样肿瘤（P = 0.02），伴有肌层深层浸润（P < 0.01），与子宫内膜增生的相关性低于CMP癌（P < 0.01）。
LUS癌主要发生在50岁以下女性中，其临床病理特征与50岁以下女性的CMP癌不同。
