Burke T W, Tortolero-Luna G, Malpica A, Baker V V, Whittaker L, Johnson E, Follen Mitchell M
Department of Gynecologic Oncology, University of Texas M. D. Anderson Cancer Center, Houston, USA.
Obstet Gynecol Clin North Am. 1996 Jun;23(2):411-56.
Endometrial cancer is the most frequently seen gynecologic neoplasm, but it fortunately has low mortality, which is due largely to its presentation with abnormal bleeding and its subsequent early diagnosis. The morbidity associated with therapy for early lesions is moderate. Hyperplasia with atypia should be treated as early cancers. Many molecular markers are currently under study. Markers may soon help us identify invasive lesions at higher risk of recurring and thus more suitable for adjunct therapy. Screening in the general population is not recommended, but a high-risk group that is more suitable for screening could be identified, including obese and nulliparous women, those treated with unopposed estrogen or tamoxifen, or those with family or past histories of breast or colon cancer. Development of chemoprevention with an oral contraceptive during the reproductive years is under way, and there may be a role for chemoprevention in the reversal of hyperplasias.
子宫内膜癌是最常见的妇科肿瘤，但幸运的是其死亡率较低，这很大程度上归因于其表现为异常出血以及随后的早期诊断。早期病变治疗相关的发病率为中度。不典型增生应作为早期癌症进行治疗。目前许多分子标志物正在研究中。这些标志物可能很快有助于我们识别复发风险较高因而更适合辅助治疗的浸润性病变。不建议在普通人群中进行筛查，但可以确定更适合筛查的高危人群，包括肥胖和未生育的女性、接受过无对抗雌激素或他莫昔芬治疗的女性，或有乳腺癌或结肠癌家族史或既往史的女性。生育期口服避孕药化学预防的研究正在进行中，化学预防在逆转增生方面可能会发挥作用。
