Kashimura M, Sugihara K, Toki N, Matsuura Y, Kawagoe T, Kamura T, Kaku T, Tsuruchi N, Nakashima H, Sakai H
Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, Kitakyushu, Japan.
Gynecol Oncol. 1997 Dec;67(3):285-90. doi: 10.1006/gyno.1997.4858.
The purpose of this study was to determine the incidence of positive peritoneal cytology and to elucidate the prognostic value of peritoneal cytology in patients with uterine cervix and endometrial cancer.
The incidence of positive peritoneal cytology was investigated in 642 patients including 339 uterine cervix and 303 endometrial cancers. Survival was estimated by the Kaplan-Meier method in a subgroup of 116 stage II cervix and 199 stage I endometrial cancers, and multivariate analysis using Cox's proportional hazards model was used to identify an independent prognostic factor.
The incidence of positive peritoneal cytology was found to be 9% in uterine cervix cancer and 15% in endometrial cancer. The incidence was higher in patients with some clinicopathologic status such as advanced stage, lymph node metastasis, ovarian metastasis, and deeper myometrial invasion. The 5-year survival rate for patients with positive or negative peritoneal cytology was 44 or 80% in stage II cervix cancers and 80 or 92% in clinical stage I endometrial cancers, respectively. Multivariate analysis revealed that independent prognostic determinants were pelvic and paraaortic lymph node metastasis and peritoneal cytology in stage II cervix cancer and peritoneal cytology in stage I endometrial cancer. Proper treatment protocol should be scheduled for patients with positive peritoneal cytology.
本研究旨在确定阳性腹膜细胞学的发生率，并阐明腹膜细胞学对子宫颈癌和子宫内膜癌患者的预后价值。
对642例患者进行了阳性腹膜细胞学发生率的调查，其中包括339例子宫颈癌和303例子宫内膜癌。采用Kaplan-Meier法对116例II期子宫颈癌和199例I期子宫内膜癌亚组患者的生存率进行了估计，并使用Cox比例风险模型进行多变量分析以确定独立的预后因素。
发现子宫颈癌阳性腹膜细胞学的发生率为9%，子宫内膜癌为15%。在一些临床病理状态（如晚期、淋巴结转移、卵巢转移和更深的肌层浸润）的患者中发生率更高。II期子宫颈癌患者腹膜细胞学阳性或阴性的5年生存率分别为44%或80%，临床I期子宫内膜癌患者为80%或92%。多变量分析显示，II期子宫颈癌的独立预后决定因素是盆腔和腹主动脉旁淋巴结转移及腹膜细胞学，I期子宫内膜癌的独立预后决定因素是腹膜细胞学。对于腹膜细胞学阳性的患者应制定适当的治疗方案。
