Schneider M L
Geburtshilfe Frauenheilkd. 1986 Jun;46(6):275-80.
This investigation pursued the question of how many patients with precancerous endometrial hyperplasia were not recommended for screening programs solely because of the lack of risk factors. The median age of precancerous hyperplasia patients in Erlangen is 54, 8 years before the median age for endometrial carcinoma. Just under 10% (8.5%) of precancerous endometria occur before the age of 45. Only 18.3% of all precancerous patients do not suffer from overweight. Because age and adiposity were missing from the list of risk factors, one quarter (23.9%) of the women studied in Erlangen had not been included in a screening program. One-fifth (19.1%) of the precancerous stages in the risk patients would not be determined cytologically because nuclear criteria were either missing or deeply situated. Consequently, a minimum failure rate of 38.5% for precancerous patients must be reckoned with when using a cytological screening routine with risk patients. In the period under study, it is surprising to note that six times as many endometrial carcinoma as precancerous endometrial were treated. There is no universally suitable treatment for all precancerous patients. Certainly, an individualized, conservative form of treatment would seem to offer more hope of success than surgical therapy, which would always be aggressive.
本研究探讨了有多少子宫内膜癌前增生患者仅仅因为缺乏危险因素而未被推荐参加筛查项目这一问题。埃尔朗根癌前增生患者的中位年龄为54岁,比子宫内膜癌的中位年龄早8年。不到10%(8.5%)的癌前子宫内膜出现在45岁之前。所有癌前患者中只有18.3%没有超重问题。由于危险因素列表中没有年龄和肥胖因素,在埃尔朗根接受研究的女性中有四分之一(23.9%)未被纳入筛查项目。风险患者中有五分之一(19.1%)的癌前阶段无法通过细胞学确定,因为要么缺乏核标准,要么核标准位置较深。因此,对风险患者采用细胞学筛查常规方法时,必须考虑到癌前患者的最低失败率为38.5%。在研究期间,值得注意的是,接受治疗的子宫内膜癌患者数量是癌前子宫内膜患者的六倍。对于所有癌前患者,不存在普遍适用的治疗方法。当然,个体化的保守治疗形式似乎比总是具有侵袭性的手术治疗更有成功的希望。