Amant Frederic, Moerman Philippe, Neven Patrick, Timmerman Dirk, Van Limbergen Erik, Vergote Ignace
Department of Obstetrics and Gynaecology, Division of Gynaecological Oncology, UZ Gasthuisberg, Katholieke Universiteit, Leuven, Belgium.
Lancet. 2005;366(9484):491-505. doi: 10.1016/S0140-6736(05)67063-8.
Each year, endometrial cancer develops in about 142,000 women worldwide, and an estimated 42,000 women die from this cancer. The typical age-incidence curve for endometrial cancer shows that most cases are diagnosed after the menopause, with the highest incidence around the seventh decade of life. The appearance of symptoms early in the course explains why most women with endometrial cancer have early-stage disease at presentation. For all stages taken together, the overall 5-year survival is around 80%. There is a substantial prognostic difference between the histological types of endometrial cancers. The most common lesions (type 1) are typically hormone sensitive and low stage and have an excellent prognosis, whereas tumours of type 2 are high grade with a tendency to recur, even in early stage. The cornerstone of treatment for endometrial cancer is surgery, which not only is important for staging purposes but also enables appropriate tailoring of adjuvant treatment modalities that benefit high-risk patients only. We review current concepts about epidemiology, pathology, pathogenesis, risk factors and prevention, diagnosis, staging, prognostic factors, treatment, and follow-up of endometrial cancer.
全球每年约有14.2万名女性罹患子宫内膜癌，估计有4.2万名女性死于这种癌症。子宫内膜癌典型的年龄发病率曲线表明，大多数病例在绝经后被诊断出来，发病高峰在70岁左右。病程早期出现症状解释了为什么大多数子宫内膜癌女性在就诊时处于疾病早期阶段。总体而言，所有分期的5年生存率约为80%。子宫内膜癌的组织学类型之间存在显著的预后差异。最常见的病变（1型）通常对激素敏感且分期低，预后良好，而2型肿瘤分级高，即使在早期也有复发倾向。子宫内膜癌治疗的基石是手术，这不仅对分期很重要，还能为仅对高危患者有益的辅助治疗方式进行适当调整。我们综述了关于子宫内膜癌的流行病学、病理学、发病机制、危险因素与预防、诊断、分期、预后因素、治疗及随访的当前概念。
