Noguchi H, Shiozawa I, Kitahara T, Yamazaki T, Fukuta T
Department of Obstetrics and Gynecology, Shinshu University School of Medicine, Matsumoto, Japan.
Gynecol Oncol. 1988 Jun;30(2):173-82. doi: 10.1016/0090-8258(88)90021-2.
To estimate the actual states of uterine body invasion of carcinoma of the uterine cervix, 301 radically hysterectomized specimens were reviewed histologically. Incidence of uterine body invasion was 21.6% in all cases (65 cases out of 301), 7.8% in stage Ib, 25.5% in stage IIa, and 38.2% in stage IIb. Most of the positive invasion cases had spread to other surrounding tissues. Vaginal wall was invaded in 58.5% of all positive cases, parametrial infiltration was recognized in 87.7%, and pelvic lymph node metastasis was seen in 52.3%. On the contrary, in negative cases these were 33.9, 19.1, and 15.7%, respectively. There was a higher incidence of the L type of Imai's CPL classification among positive cases of uterine body invasion than among negative cases (81.5% vs 38.1%). When cervical cancer spread into the uterine body, peritoneal carcinomatosis and distant metastasis increased. Thus the outcome of patients with positive invasion was, naturally, poor. Patients with negative invasion had a 5-year survival rate of 92.4%, compared to 53.8% in patients with positive uterine body invasion. These results suggest that uterine body invasion of carcinoma of the uterine cervix is an important prognostic factor and treatment should be modified in such cases.
为评估子宫颈癌子宫体浸润的实际情况，对301例根治性子宫切除标本进行了组织学检查。所有病例中子宫体浸润的发生率为21.6%（301例中有65例），Ib期为7.8%，IIa期为25.5%，IIb期为38.2%。大多数阳性浸润病例已扩散至其他周围组织。所有阳性病例中58.5%侵犯阴道壁，87.7%可见宫旁浸润，52.3%可见盆腔淋巴结转移。相反，阴性病例中这些比例分别为33.9%、19.1%和15.7%。子宫体浸润阳性病例中Imai的CPL分类L型的发生率高于阴性病例（81.5%对38.1%）。当宫颈癌扩散至子宫体时，腹膜种植和远处转移增加。因此，浸润阳性患者的预后自然较差。浸润阴性患者的5年生存率为92.4%，而子宫体浸润阳性患者为53.8%。这些结果表明，子宫颈癌的子宫体浸润是一个重要的预后因素，在这种情况下应调整治疗方案。
