Kaku T, Tsukamoto N, Tsuruchi N, Sugihara K, Kamura T, Nakano H
Department of Gynecology and Obstetrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Obstet Gynecol. 1992 Nov;80(5):812-6.
To clarify the relationship of metaplasia to endometrial carcinoma.
Between 1984-1990, 73 cases of stage I-II endometrial carcinoma treated initially by hysterectomy were reviewed histologically. The metaplasias were classified as squamous, syncytial papillary, ciliated-cell, eosinophilic, mucinous, clear-cell, or hobnail. We assessed the histologic type and grade of the carcinoma, depth of myometrial invasion, presence or absence of lymph-vascular space invasion, and presence or absence of lymph node metastases.
Forty of 73 patients (55%) had one or more areas of metaplasia in the endometrium adjacent to the carcinoma. Ciliated-cell metaplasia (28 of 73; 38%) was the most common type encountered. Women with both endometrial carcinoma and metaplasia were significantly younger than those with carcinoma without metaplasia (P < .05). Compared with carcinomas without metaplasia, those with metaplasia were well differentiated (P < .01) and lacked myometrial invasion (P < .01) and pelvic lymph node metastases (P < .05). The presence of metaplasia was also significantly correlated with the presence of endometrial hyperplasia (P < .01).
In endometrial carcinomas, the presence of endometrial metaplasia suggests a favorable prognosis.
阐明化生与子宫内膜癌的关系。
回顾性分析1984年至1990年间73例最初接受子宫切除术治疗的Ⅰ - Ⅱ期子宫内膜癌患者的组织学情况。化生类型分为鳞状化生、合体细胞乳头化生、纤毛细胞化生、嗜酸性化生、黏液性化生、透明细胞化生或鞋钉样化生。我们评估了癌的组织学类型和分级、肌层浸润深度、有无淋巴血管间隙浸润以及有无淋巴结转移。
73例患者中有40例（55%）在癌灶旁的子宫内膜有一个或多个化生区域。纤毛细胞化生最为常见（73例中有28例；38%）。患有子宫内膜癌且有化生的女性比无化生的癌患者明显年轻（P < .05）。与无化生的癌相比，有化生的癌分化良好（P < .01），无肌层浸润（P < .01）且无盆腔淋巴结转移（P < .05）。化生的存在也与子宫内膜增生的存在显著相关（P < .01）。
在子宫内膜癌中，子宫内膜化生的存在提示预后良好。
