Mitsumoto T, Horii T, Sawatari Y, Noda K
Department of Obstetrics and Gynecology, Kinki University School of Medicine.
Nihon Gan Chiryo Gakkai Shi. 1990 Aug 20;25(8):1648-51.
The study included a total of 634 patients with cervical cancer; 311 were in stage I b and 323 were in stage II. All patients received radical hysterectomy at the Department of Obstetrics and Gynecology, Kinki University, between May 1975 and December 1986. One out of 311 patients in stage I b (0.3%) and eight out of 323 patients in stage II (2.5%) had ovarian metastases confirmed histologically. Nine patients who had ovarian metastases were investigated about stages, histological types of the cervical cancer (WHO and CPL classification), incidence of metastases in pelvic lymph nodes, corpus infiltration, parametrial infiltration, and peritoneal cytology. Results obtained were as follows: 1. As to histological types, patients with adenocarcinoma and/or PL type in CPL classification had high incidence of ovarian metastases. 2. Patients with corpus infiltration had high incidence of ovarian metastases. 3. Metastases to both ovary and pelvic lymph nodes tended to occur on the same side, but ovarian metastases and parametrial infiltration did not necessarily occur on the same side. We suggest removal of ovaries, even before menopause, in patients with cervical cancer who have cervical adenocarcinoma, or corpus infiltration, or are suspicious for metastases in more than two pelvic lymph nodes.
该研究共纳入634例宫颈癌患者；其中311例为Ⅰb期，323例为Ⅱ期。1975年5月至1986年12月期间，所有患者均在近畿大学妇产科接受了根治性子宫切除术。Ⅰb期的311例患者中有1例（0.3%）、Ⅱ期的323例患者中有8例（2.5%）经组织学证实有卵巢转移。对9例有卵巢转移的患者进行了分期、宫颈癌组织学类型（世界卫生组织和CPL分类）、盆腔淋巴结转移发生率、宫体浸润、宫旁浸润及腹水细胞学检查。结果如下：1. 组织学类型方面，CPL分类中腺癌和/或PL型患者卵巢转移发生率较高。2. 有宫体浸润的患者卵巢转移发生率较高。3. 卵巢和盆腔淋巴结转移倾向于发生在同一侧，但卵巢转移和宫旁浸润不一定发生在同一侧。我们建议，对于患有宫颈腺癌、或有宫体浸润、或怀疑有两个以上盆腔淋巴结转移的宫颈癌患者，即使在绝经前也应切除卵巢。
