Kasai T, Takeda B, Takamizawa H
Nihon Sanka Fujinka Gakkai Zasshi. 1984 Jun;36(6):865-74.
Clinical, cytological and hormonal studies were performed on 86 cases of endometrial carcinoma and 34 cases of endometrial hyperplasia for their early diagnosis. 68.6% of the endometrial carcinomas were in patients aged 50 to 64 and 3.5% in patients under 45 ages. The figures 17.4% infertility, 20.9% no delivery and 19.8% only one delivery indicate that endometrial carcinoma is associated with no birth or the birth of few child. Almost all cases of endometrial carcinoma had existed for more than ten years since the last pregnancy, when the lesions were detected. 20.9% of endometrial carcinomas belonged to premenopause and 24.4% to within the first 5 years following menopause. In total, 45.3% of them range around menopause and hormonal imbalance in climacteric periods. Clinical stages of endometrial carcinoma revealed no relation to enlargement of the uterus. 61.4% of endometrial carcinoma were found in obese patients. 63.1% of them showed abnormal glucose tolerance titers and preclinical lesions. Hypertension was found in 28.0% of them, but we did not consider it very significant, considering their advanced age. The serum steroid level indicated no hyperestrogenism in endometrial carcinoma. Diagnostic data showing positive and suspecious smears in endometrial carcinoma were 36.5% in vaginal, 67.5% in cervical and 84.3% in endometrial cytology. This means that direct sampling of cells from the uterine cavity is essential in the detection of endometrial carcinoma. The cytological features of endometrial carcinoma were nuclear enlargement, anisokaryosis, irregular distribution of chromatin and prominent nucleoli. Undifferentiated types of endometrial carcinoma were more characterized by these factors than differentiated types.
为实现早期诊断,对86例子宫内膜癌患者和34例子宫内膜增生患者进行了临床、细胞学和激素研究。68.6%的子宫内膜癌患者年龄在50至64岁之间,3.5%的患者年龄在45岁以下。17.4%的患者有不孕史、20.9%的患者未生育、19.8%的患者仅生育一胎,这些数据表明子宫内膜癌与未生育或生育子女较少有关。几乎所有子宫内膜癌病例自上次怀孕后病变被发现时起已存在十余年。20.9%的子宫内膜癌属于绝经前,24.4%的病例发生在绝经后的前5年内。总体而言,45.3%的病例发生在绝经前后及更年期激素失衡阶段。子宫内膜癌的临床分期与子宫增大情况无关。61.4%的子宫内膜癌患者为肥胖患者。其中63.1%的患者糖耐量试验结果异常且有临床前病变。28.0%的患者患有高血压,但考虑到他们年龄较大,我们认为这一比例并不十分显著。子宫内膜癌患者的血清类固醇水平未显示出高雌激素血症。子宫内膜癌阴道涂片、宫颈涂片及子宫内膜细胞学涂片诊断数据显示阳性和可疑涂片分别为36.5%、67.5%和84.3%。这意味着在子宫内膜癌的检测中,直接从子宫腔取样细胞至关重要。子宫内膜癌的细胞学特征为细胞核增大、核大小不均、染色质分布不规则及核仁明显。未分化型子宫内膜癌比分化型更具有这些特征。