Grimshaw R N, Tupper W C, Fraser R C, Tompkins M G, Jeffrey J F
Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada.
Gynecol Oncol. 1990 Jan;36(1):97-100. doi: 10.1016/0090-8258(90)90116-3.
To determine whether positive peritoneal cytology is an independent poor prognostic factor in patients with endometrial carcinoma the records of 381 patients were reviewed. Positive peritoneal cytology was found in 24 of 381 (6.3%) patients. In clinical stage I disease, 16 of 322 (5.0%) patients had positive peritoneal cytology. Patients with positive cytology were more likely to have higher-grade tumors and extrauterine disease at the time of surgery (45% vs 2.3%) than were patients with negative cytology. Five-year survival was significantly less for patients with positive cytology than negative (50% vs 81.2%). For patients with surgical stage I disease (no extrauterine spread at surgery) there was no significant difference in 5-year survival between groups with positive and negative cytology (80% vs 86.3%). The majority (70.8%) of patients with endometrial cancer and positive peritoneal cytology have extrauterine disease at the time of surgery. Although overall 5-year survival is less for patients with positive cytology, when other risk factors are controlled for, there is no difference in survival for patients with no demonstrable extrauterine disease despite positive cytology. We conclude that positive peritoneal cytology is not an independent prognostic indicator for patients with endometrial cancer.
为了确定阳性腹腔细胞学检查是否为子宫内膜癌患者的独立不良预后因素，我们回顾了381例患者的记录。381例患者中有24例（6.3%）腹腔细胞学检查呈阳性。在临床I期疾病中，322例患者中有16例（5.0%）腹腔细胞学检查呈阳性。与腹腔细胞学检查阴性的患者相比，腹腔细胞学检查阳性的患者在手术时更有可能患有高级别肿瘤和子宫外疾病（45%对2.3%）。腹腔细胞学检查阳性的患者5年生存率明显低于阴性患者（50%对81.2%）。对于手术分期为I期的患者（手术时无子宫外扩散），腹腔细胞学检查阳性和阴性组之间的5年生存率没有显著差异（80%对86.3%）。大多数（70.8%）子宫内膜癌且腹腔细胞学检查阳性的患者在手术时有子宫外疾病。虽然腹腔细胞学检查阳性的患者总体5年生存率较低，但在控制其他风险因素后，尽管腹腔细胞学检查阳性，但无可证实子宫外疾病的患者生存率没有差异。我们得出结论，阳性腹腔细胞学检查不是子宫内膜癌患者的独立预后指标。
