Olawaiye Alexander B, Boruta David M
University of Pittsburgh Medical Center (UPMC), Magee-Women's Hospital, Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, Pittsburgh, Pennsylvaniaa, PA 15213, USA.
Gynecol Oncol. 2009 May;113(2):277-83. doi: 10.1016/j.ygyno.2009.02.003. Epub 2009 Feb 28.
Clear cell endometrial cancer (CCE) is an uncommon but important disease because of its aggressive behavior. Furthermore, prospective, randomized studies are either too difficult or impossible because of the small number of women affected. This review explores the differences between clear cell and endometrioid endometrial cancer. In addition, it uses available evidence to determine the best approach to management.
Medline was searched between January 1, 1966 and December 31, 2008 for all publications in English where the studied population included women diagnosed with CCE. Qualifying studies must have had at least 30 patients.
Clear cell histology is diagnosed in less than 6% of all endometrial cancers and its incidence increases with age. Diagnosis can be made using the same tests that are used in the diagnosis of other types of endometrial cancer. Clear cell histology is morphologically and genetically different from the more prevalent endometrioid endometrial cancer histology. It shares many similarities with clear cell neoplasms of the ovary and kidney. Comprehensive surgical staging is critical in order to plan appropriate postoperative management. Adjuvant pelvic and/or whole abdominal radiotherapy have not been shown to be clearly beneficial in women diagnosed with clear cell endometrial cancer. Adjuvant chemotherapy with cisplatinum, taxol and doxorubicin either in a doublet or triplet combination has demonstrated efficacy.
Women diagnosed with CCE require comprehensive surgical staging. Platinum based adjuvant chemotherapy in a doublet or triplet format in combination with paclitaxel and/or doxorubicin should be considered as part of treatment of these women. Careful long term surveillance following treatment is indicated given the higher rate of recurrence compared to endometrioid endometrial cancer.
透明细胞子宫内膜癌（CCE）虽不常见但因具有侵袭性而成为一种重要疾病。此外，由于患病人数少，前瞻性随机研究要么难度极大，要么根本无法开展。本综述探讨透明细胞子宫内膜癌与子宫内膜样腺癌之间的差异。此外，还利用现有证据确定最佳治疗方法。
检索1966年1月1日至2008年12月31日期间Medline收录的所有英文出版物，研究人群包括被诊断为CCE的女性。符合条件的研究必须至少有30名患者。
在所有子宫内膜癌中，透明细胞组织学诊断的比例不到6%，其发病率随年龄增长而增加。可使用与诊断其他类型子宫内膜癌相同的检测方法进行诊断。透明细胞组织学在形态和基因上与更常见的子宫内膜样癌组织学不同。它与卵巢和肾脏的透明细胞瘤有许多相似之处。全面的手术分期对于规划适当的术后管理至关重要。对于诊断为透明细胞子宫内膜癌的女性，辅助盆腔和/或全腹放疗并未显示出明显益处。顺铂、紫杉醇和阿霉素联合使用的双药或三药辅助化疗已显示出疗效。
诊断为CCE的女性需要全面的手术分期。应考虑以铂类为基础的双药或三药辅助化疗联合紫杉醇和/或阿霉素作为这些女性治疗的一部分。鉴于与子宫内膜样腺癌相比复发率较高，治疗后需要进行仔细的长期监测。
