King A, Seraj I M, Wagner R J
Am J Obstet Gynecol. 1984 May 1;149(1):10-4. doi: 10.1016/0002-9378(84)90283-7.
The ability to predict myometrial invasion by endometrial adenocarcinoma is useful for preoperative treatment purposes. The presence of stromal invasion is one possible method of predicting myometrial invasion, but criteria for the presence of stromal invasion have been lacking. Recently, criteria for its detection were proposed. We evaluated the validity of the proposed criteria in two conditions: (1) atypical hyperplasia (119 cases) and (2) endometrial adenocarcinoma Stage I, grade 1 (83 cases). Adenocarcinoma without stromal invasion according to the criteria of Kurman and Norris was present in 43 cases and adenocarcinoma with stromal invasion was present in 40 cases. This series demonstrated the ability of prehysterectomy endometrial sampling to predict the probability of myometrial penetration. In addition, none of our patients without stromal invasion in the resected uterus had myometrial penetration and no metastases have occurred. In those showing stromal invasion in the excised uterus, the myometrium was invaded in 34 of 51 cases (67%). Since myometrial penetration was not present when there was no stromal invasion in the resected uterus, stromal invasion deserves further evaluation and should be considered in future classification of endometrial adenocarcinoma.
预测子宫内膜腺癌肌层浸润的能力对于术前治疗目的很有用。间质浸润的存在是预测肌层浸润的一种可能方法，但一直缺乏间质浸润存在的标准。最近，提出了其检测标准。我们在两种情况下评估了所提出标准的有效性：（1）非典型增生（119例）和（2）子宫内膜腺癌Ⅰ期、1级（83例）。根据Kurman和Norris标准无间质浸润的腺癌有43例，有间质浸润的腺癌有40例。该系列研究证明了子宫切除术前子宫内膜取样预测肌层浸润可能性的能力。此外，我们切除的子宫中无间质浸润的患者均无肌层浸润且未发生转移。在切除的子宫中显示有间质浸润的患者中，51例中有34例（67%）肌层受到侵犯。由于切除的子宫中无间质浸润时不存在肌层浸润，间质浸润值得进一步评估，并且应在未来子宫内膜腺癌的分类中予以考虑。
