Pearl M L, Griffen T, Valea F A, Chalas E
Department of Obstetrics, Gynecology and Reproductive Medicine, State University of New York at Stony Brook, 11794-8091, USA.
Gynecol Oncol. 1997 Mar;64(3):442-5. doi: 10.1006/gyno.1996.4590.
The objective of this study was to assess the clinical utility of a pretreatment barium enema in women with endometrial cancer.
The medical records of 249 patients with endometrial cancer who underwent a pretreatment barium enema were retrospectively reviewed. The patients' charts were abstracted for demographic information, stage, grade, histology, current disease status, and barium enema results.
The pretreatment barium enema was normal in 122 (49%) patients. Diverticulosis was the most common abnormality, reported in 112 (45%) patients. Apparent intraluminal abnormalities were found in 15 (6.0%) patients. Each of these patients underwent colonoscopy prior to treatment for endometrial carcinoma. During colonoscopy, benign colonic polyps were removed from 11 (4.4%) patients. Primary colonic adenocarcinoma was discovered in polypoid lesions removed from 2 (0.8%) patients. Significant luminal narrowing from extrinsic lesions was noted in 2 (0.8%) patients, one at the rectosigmoid and the other at the cecum. No patient was found to have colonic mucosal involvement by endometrial cancer.
The results of this study do not justify routine pretreatment barium enema to assess the colonic mucosa for metastatic involvement by endometrial cancer or as a screening tool for colorectal cancer in women with endometrial cancer.
本研究的目的是评估子宫内膜癌女性患者术前钡剂灌肠的临床实用性。
对249例行术前钡剂灌肠的子宫内膜癌患者的病历进行回顾性分析。从患者病历中提取人口统计学信息、分期、分级、组织学、当前疾病状态及钡剂灌肠结果。
122例（49%）患者术前钡剂灌肠结果正常。憩室病是最常见的异常情况，112例（45%）患者有此情况。15例（6.0%）患者发现明显的腔内异常。这些患者在接受子宫内膜癌治疗前均接受了结肠镜检查。结肠镜检查期间，11例（4.4%）患者切除了良性结肠息肉。从2例（0.8%）患者切除的息肉样病变中发现原发性结肠腺癌。2例（0.8%）患者发现因外部病变导致的明显管腔狭窄，1例位于直肠乙状结肠交界处，另1例位于盲肠。未发现患者有子宫内膜癌侵犯结肠黏膜的情况。
本研究结果表明，对于评估子宫内膜癌患者结肠黏膜是否存在转移或作为子宫内膜癌女性患者结直肠癌的筛查工具，术前常规进行钡剂灌肠并无必要。
