Robboy S J, Bradley R
Obstet Gynecol. 1979 Sep;54(3):269-77.
A study was undertaken to investigate changing trends in the microscopic patterns of endometrial carcinoma and to compare the biologic characteristics of those cases associated with and without estrogen usage. After each case was reviewed independently and in a random order by at least 2 pathologists, a diagnosis of cancer was agreed on in 274 patients who had been treated by 5 gynecologists at the Masachusetts General Hospital between 1940 and 1971. Six microscopic patterns were identified (adenocarcinoma, adenoacanthoma, atypical adenoacanthoma, adenosquamous carcinoma, clear-cell adenocarcinoma, and undifferentiated carcinoma). The frequency of each pattern relative to the other 5 changed only slightly during the 30-year interval. The tumors that developed in estrogen users were more highly differentiated than those that developed in nonusers (P less than 0.005) and were found at an earlier average age (P less than 0.02). That the adenoacanthoma was associated with estrogen usage more frequently (51%) than any other tumor type (P less than 0.02) may reflect, in part, a similar and lower mean age of estrogen users (56 years) and patients with adenoacanthoma (55 years) compared with that of nonusers with the other forms of tumors (60--67 years). Although the overall 5- and 10-year survival rates of the estrogen users were higher than those of the nonusers, the differences between the 2 groups disappeared when the grade of the neoplasm was considered.
开展了一项研究，以调查子宫内膜癌微观模式的变化趋势，并比较使用和未使用雌激素的病例的生物学特征。在至少2名病理学家独立且随机地对每个病例进行复查后，对1940年至1971年间在马萨诸塞州总医院由5名妇科医生治疗的274例患者确诊为癌症。识别出六种微观模式（腺癌、腺棘皮癌、非典型腺棘皮癌、腺鳞癌、透明细胞腺癌和未分化癌）。在30年的时间间隔内，每种模式相对于其他5种模式的频率变化很小。使用雌激素的患者所患肿瘤的分化程度高于未使用雌激素的患者（P<0.005），且发病的平均年龄更早（P<0.02）。腺棘皮癌与雌激素使用的关联比其他任何肿瘤类型都更频繁（51%）（P<0.02），这可能部分反映了与其他形式肿瘤的未使用者（60 - 67岁）相比，雌激素使用者（56岁）和腺棘皮癌患者（55岁）的平均年龄相似且较低。尽管使用雌激素的患者的总体5年和10年生存率高于未使用者，但在考虑肿瘤分级时，两组之间的差异消失了。
