Kaku T, Tsukamoto N, Hachisuga T, Tsuruchi N, Sakai K, Hirakawa T, Amada S, Saito T, Kamura T, Nakano H
Department of Gynecology and Obstetrics, Faculty of Medicine, Kyushu University 60, Fukuoka, Japan.
Gynecol Oncol. 1996 Jan;60(1):22-5. doi: 10.1006/gyno.1996.0005.
The aim of this study was to clarify the relationship of endometrial hyperplasia to endometrial carcinoma. From 1979 through 1990, 115 cases of stage I-IV endometrial carcinomas treated initially by hysterectomy were reviewed histologically. Forty-two of 115 (36.3%) patients had hyperplasia in the endometrium adjacent to the carcinoma. Women with both endometrial carcinoma and hyperplasia were significantly younger than those with carcinoma without hyperplasia (P < 0.05). In a comparison of patients with carcinoma without hyperplasia, those with hyperplasia were better differentiated (P = 0.0072), and lacked deep myometrial invasion (P < 0.0001), cervical involvement (P = 0.0192), lymph-vascular space invasion (P = 0.0102), and para-aortic lymph node metastases (P = 0.0434). The presence of endometrial metaplasia (P = 0.0001). The estimated 5-year survival rates for patients with carcinoma with hyperplasia and those with carcinoma without hyperplasia were 96.55 and 73.33%, respectively (P = 0.0016). In endometrial carcinomas, the presence of endometrial hyperplasia may demonstrate a more favorable prognosis.
本研究的目的是阐明子宫内膜增生与子宫内膜癌之间的关系。对1979年至1990年间最初接受子宫切除术治疗的115例I-IV期子宫内膜癌病例进行了组织学回顾。115例患者中有42例（36.3%）在癌灶附近的子宫内膜有增生。患有子宫内膜癌且伴有增生的女性明显比患有无增生性癌的女性年轻（P<0.05）。在对无增生性癌患者的比较中，有增生的患者分化更好（P = 0.0072），且无肌层深部浸润（P<0.0001）、宫颈受累（P = 0.0192）、淋巴管间隙浸润（P = 0.0102）和主动脉旁淋巴结转移（P = 0.0434）。存在子宫内膜化生（P = 0.0001）。伴有增生的癌患者和无增生的癌患者的估计5年生存率分别为96.55%和73.33%（P = 0.0016）。在子宫内膜癌中，子宫内膜增生的存在可能预示着更良好的预后。
