Goff B A, Rice L W
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Gynecol Oncol. 1990 Jul;38(1):46-8. doi: 10.1016/0090-8258(90)90009-a.
Depth of myometrial invasion in stage I adenocarcinoma of the endometrium is recognized as a prognostic factor for lymph node metastasis and overall survival. To determine if depth of myometrial invasion estimated by gross examination correlated with final histologic depth of invasion, we retrospectively reviewed all cases of surgical stage I endometrial adenocarcinoma treated at our institution between July 1985 and July 1988. Of the 113 evaluable patients, 63 had grade 1 lesions, 37 grade 2 lesions, and 13 grade 3 lesions. The depth of invasion was accurately determined by gross examination in 55 of 63 (87.3%) grade 1 lesions, 24 of 37 (64.9%) grade 2 lesions, and only 4 of 13 (30.8%) grade 3 lesions. Thus, gross examination of fresh tissue to estimate depth of myometrial invasion in endometrial adenocarcinoma is less reliable as the grade of the tumor increases. Alternative methods, such as frozen section, should be considered when evaluating depth of invasion, especially when this affects intraoperative decisions regarding lymph node sampling.
子宫内膜癌I期肌层浸润深度被认为是淋巴结转移和总生存期的一个预后因素。为了确定大体检查估计的肌层浸润深度与最终组织学浸润深度是否相关，我们回顾性分析了1985年7月至1988年7月间在本机构接受手术治疗的所有I期子宫内膜腺癌病例。在113例可评估患者中，63例为1级病变，37例为2级病变，13例为3级病变。63例1级病变中有55例（87.3%）通过大体检查准确确定了浸润深度，37例2级病变中有24例（64.9%），而13例3级病变中只有4例（30.8%）。因此，随着肿瘤分级增加，通过大体检查新鲜组织来估计子宫内膜腺癌肌层浸润深度的可靠性降低。在评估浸润深度时，尤其是当这影响到术中关于淋巴结取样的决策时，应考虑采用冰冻切片等替代方法。
