Geszler G, Szpak C A, Harris R E, Creasman W T, Barter J F, Johnston W W
Am J Obstet Gynecol. 1986 Jul;155(1):83-9. doi: 10.1016/0002-9378(86)90084-0.
Peritoneal washings from 36 women with all pathologic stages of mixed müllerian tumors of the uterus (27 homologous stroma, nine heterologous stroma) were reviewed in a blinded retrospective fashion for the presence and type of malignant cells collected. Malignant tumor cells were demonstrated in the washings of 16 patients; 13 contained adenocarcinoma only, two contained adenocarcinoma and sarcoma, and one contained sarcoma cells only. Cox's logistic regression analysis showed that cytologic examination of peritoneal washings when combined with pathologic staging provides a statistically significant discriminant of disease-free survival. Patients with a favorable prognosis (pathologic Stage I and peritoneal washings free of malignancy) had sevenfold increased disease-free survival compared with survival of the patients with an unfavorable prognosis (pathologic Stages II, III, or IV or malignant cells present in peritoneal washings). Three of the 18 patients with pathologic Stage I disease manifested malignant tumor cells in the peritoneal washings and all three patients died of disease in less than 1 year. The presence of malignant cells in peritoneal washings in patients with mixed müllerian tumor apparently limited to the uterus suggests a clinical course that is similar to that of those with more advanced disease.
对36例处于子宫混合性苗勒管肿瘤各病理分期的女性患者（27例同源间质型，9例异源间质型）的腹腔冲洗液进行了盲法回顾性分析，以确定所收集的恶性细胞的存在情况和类型。16例患者的冲洗液中发现了恶性肿瘤细胞；13例仅含有腺癌，2例含有腺癌和肉瘤，1例仅含有肉瘤细胞。Cox逻辑回归分析表明，腹腔冲洗液的细胞学检查与病理分期相结合，对无病生存期具有统计学上显著的判别能力。预后良好的患者（病理I期且腹腔冲洗液无恶性肿瘤）的无病生存期比预后不良的患者（病理II、III或IV期或腹腔冲洗液中有恶性细胞）增加了7倍。18例病理I期疾病患者中有3例腹腔冲洗液中出现恶性肿瘤细胞，且这3例患者均在不到1年的时间内因疾病死亡。子宫混合性苗勒管肿瘤患者腹腔冲洗液中存在恶性细胞，这显然表明其临床病程与疾病进展更严重的患者相似。
