Goff B A, Kato D, Schmidt R A, Ek M, Ferry J A, Muntz H G, Cain J M, Tamimi H K, Figge D C, Greer B E
Department of Obstetrics and Gynecology, University of Washington, Seattle 98195.
Gynecol Oncol. 1994 Sep;54(3):264-8. doi: 10.1006/gyno.1994.1208.
Uterine papillary serous carcinoma (UPSC) is a distinct histologic type of endometrial cancer which is associated with a high relapse rate and poor prognosis. Between 1983 and 1993, 50 patients with UPSC of the endometrium were surgically staged. Thirty-three patients had pure UPSC and 17 had UPSC admixed with other histologies. Extrauterine disease was found in 36 women (72%). Lymph node metastases were present in 36% of women without myometrial invasion, 50% with inner one-half invasion, and 40% with outer one-half invasion. Similarly, the presence of intraperitoneal disease or positive washings did not correlate with increasing myometrial invasion. Grade and histology (mixed vs pure) were also not predictive of extrauterine disease. Patients with lymphatic/vascular space invasion (LVSI) were more likely to have extrauterine disease (85%); however, even without LVSI the incidence of extrauterine disease was 58% (P = 0.05). Unlike endometrioid adenocarcinomas, grade and depth of myometrial invasion were not significant predictors for extrauterine disease. This study reinforces the need for complete surgical staging in all patients with UPSC regardless of depth of invasion.
子宫浆液性乳头状癌（UPSC）是一种独特的子宫内膜癌组织学类型，其复发率高且预后较差。1983年至1993年间，对50例子宫内膜UPSC患者进行了手术分期。33例患者为单纯UPSC，17例患者的UPSC与其他组织学类型混合存在。36名女性（72%）发现有子宫外病变。在未发生肌层浸润的女性中，36%有淋巴结转移；肌层内1/2浸润的女性中，50%有淋巴结转移；肌层外1/2浸润的女性中，40%有淋巴结转移。同样，腹腔内病变或腹水阳性与肌层浸润增加无关。分级和组织学类型（混合性与单纯性）也不能预测子宫外病变。有淋巴/血管间隙浸润（LVSI）的患者更有可能出现子宫外病变（85%）；然而，即使没有LVSI，子宫外病变的发生率也为58%（P = 0.05）。与子宫内膜样腺癌不同，肌层浸润的分级和深度不是子宫外病变的重要预测指标。这项研究强调，对于所有UPSC患者，无论浸润深度如何，都需要进行完整的手术分期。
