Philippe E, Muller J, Ritter J
Rev Fr Gynecol Obstet. 1987 May;82(5):331-5.
Endometrial carcinoma is significantly linked to the excess of exogenous and endogenous estrogens, non-tempered by progesterone. It is the second cancer in women after breast cancer. It is still detected with difficulty at the pre-invasive stage. Evaluation of its histological grade during the diagnosis (aspiration, curettage) influences the treatment. Grade I (80 p. cent of the cases) includes common carcinomas and their mucinous variants, with malpighian metaplasia, cytologically benign. Grade II concerns poorly differentiated carcinomas. Grade III concerns adeno squamous, anaplastic, seropapillar and clear cells carcinomas. The invasive stage, established on the operative specimen, represent the main prognostic factor. The risks of recurrence or metastases are practically non-existent when the carcinoma is localized to the endometrium, very low if the carcinoma invades a few mm of the myometrium, moderate if the medial half is involved, much higher if the invasion exceeds half of the thickness of the myometrium and/or involves the cervix.
子宫内膜癌与外源性和内源性雌激素过多显著相关,且未受孕激素调节。它是女性继乳腺癌之后的第二大癌症。在浸润前期仍难以检测到。诊断(抽吸、刮宫)时对其组织学分级的评估会影响治疗。I级(80%的病例)包括常见癌及其黏液性变体,伴有马尔皮基化生,细胞学上为良性。II级涉及低分化癌。III级涉及腺鳞癌、间变性癌、浆液乳头癌和透明细胞癌。基于手术标本确定的浸润期是主要的预后因素。当癌局限于子宫内膜时,复发或转移的风险实际上不存在;如果癌侵犯肌层几毫米,风险非常低;如果累及肌层内侧一半,风险中等;如果侵犯超过肌层厚度的一半和/或累及宫颈,风险则高得多。