Mikuta J J
University of Pennsylvania School of Medicine, Philadelphia 19104.
Cancer. 1993 Feb 15;71(4 Suppl):1460-3. doi: 10.1002/cncr.2820710409.
In 1988, the International Federation of Gynecology and Obstetrics (FIGO) Cancer Committee changed the staging of endometrial carcinoma from a clinical one to a surgicopathologic one. The emphasis in the new FIGO system was changed to the pathologic findings in the uterus, cervix, adnexa, and pelvic and/or periaortic nodes, and peritoneal cytologic findings. The major changes in this staging system were (1) the use of the depth of myometrial invasion and (2) the identification of tumor cells in peritoneal cytologic examination and of invasion in the retroperitoneal lymph nodes. Preoperative endocervical curettage was no longer necessary. Currently, the high level of operability of patients with endometrial carcinoma makes this staging system a viable one, which will provide information about the need for additional treatment. The use of the grading system for the tumor also was refined to upgrade nuclear changes that were inappropriate for the architectural grade. In serous adenocarcinomas, clear cell adenocarcinomas, and squamous cell carcinomas, nuclear grading took precedence. Adenocarcinomas with squamous differentiation were graded according to the nuclear grade of the glandular component.
1988年，国际妇产科联合会（FIGO）癌症委员会将子宫内膜癌的分期从临床分期改为手术病理分期。新的FIGO系统重点转向子宫、宫颈、附件、盆腔和/或腹主动脉旁淋巴结的病理检查结果以及腹腔细胞学检查结果。该分期系统的主要变化包括：（1）采用肌层浸润深度；（2）在腹腔细胞学检查中识别肿瘤细胞以及在腹膜后淋巴结中识别浸润情况。术前不再需要进行宫颈管刮除术。目前，子宫内膜癌患者较高的手术可操作性使该分期系统切实可行，可为是否需要进一步治疗提供依据。肿瘤分级系统也得到了完善，以提升那些与结构分级不相符的核改变的分级。在浆液性腺癌、透明细胞腺癌和鳞状细胞癌中，核分级优先。伴有鳞状分化的腺癌根据腺性成分的核分级进行分级。
