中国实用妇科与产科杂志

中国实用妇科与产科杂志

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子宫肉瘤临床特点及预后相关因素101例分析

佟晓晶，李联昆   

  1. 作者单位：辽宁省肿瘤医院妇科，辽宁 沈阳 110042
  • 出版日期:2014-11-02 发布日期:2014-11-07

A clinical analysis and prognosis of 101 uterine sarcoma.

TONG Xiao-jing,LI Lian-kun.   

  1. Department of Gynecology,Liaoning Cancer Hospital,Shenyang 110042,China
  • Online:2014-11-02 Published:2014-11-07

摘要：

目的 探讨子宫肉瘤的临床特点及预后相关因素,以改善其生存率。方法 对辽宁省肿瘤医院1984年2月至2008年8月收治的101例子宫肉瘤的组织学类型、临床特点、治疗方法及预后进行回顾性分析。结果 101例子宫肉瘤患者5年总生存率为46.5%。单因素分析显示:年龄≤52岁组的5年生存率为57.1%,>52岁组为36.5%,差异有统计学意义(χ2=5.915,P=0.003）。绝经前患者5年生存率为57.6%,绝经后患者为25.7%(χ2=9.332，P=0.002 )。子宫平滑肌肉瘤5年生存率34.3%,恶性中胚叶混合瘤为16.7%,子宫内膜间质肉瘤为73.8%,三者比较差异有统计学意义(χ2=23.274，P<0.001)。Ⅰ期与Ⅱ、Ⅲ、Ⅳ期的5年生存率分别为61.1%、36.4%、18.2%、0%，差异有统计学意义(χ2=9.428，P=0.009)。当子宫体积<妊娠3个月子宫时,5年生存率为65.2%,而≥3个月时为41.0%(χ2=4.178，P=0.041 )。手术、手术+放疗+化疗、手术+化疗、手术+放疗者5年生存率分别为41.7%、62.5%、45.9%、44.4%,差异无统计学意义(χ2=4.390，P=0.375)。多因素分析显示:仅绝经状态、手术分期和病理类型3个因素与患者的预后有关,其中手术分期是影响患者预后的最重要因素（P=0.001）。结论    绝经状态、手术分期、病理类型是影响子宫肉瘤患者预后的独立因素。 

关键词: 子宫肉瘤, 临床特点, 预后因素

Abstract:

Abstract： Objective To investigate the prognostic factors of uterine sarcomas and to improve its survival rate.Methods One hundred and one patients with uterine sarcoma from Department of Gynecology,Liaoning Cancer Hospital,China were retrospectively reviewed from 1984 to 2008.Results The overall 5-year survival rate was 46.5%. Univariate analysis showed that:patients under 52 had a better survival rate than those over 52 (χ2=5.915,P=0.003).Premenopausal patients’5-year survival rate was 57.6%, while postmenopausal patients’ was 25.7%(χ2=9.332,P=0.002 ). The 5-year survival rate of leiomyosarcoma was 34.3%, mixed mesodermal tumors was 16.7%, and endometrial stromal sarcoma was 73.8%(χ2=23.274,P<0.001).The 5-year survival rates of StageⅠ,Ⅱ,Ⅲand Ⅳ were 61.1%, 36.4%, 18.2% and 0%,respectively (χ2=9.428, P=0.009). When uterine volume was less than 3 months of pregnancy uterine size, the 5-year survival rate was 65.2%, while for greater than 3 months’it was 41.0% (χ2=4.178,P=0.041).The 5-year survival rates of surgery,surgery+ radiotherapy + chemotherapy, surgery + chemotherapy, surgery and radiotherapy were 41.7%,62.5%,45.9% and 44.4% (χ2=4.390,P=0.375).The prognostic factors based on multivariate analysis were menopause status ,surgical staging,and histological type. Surgical staging was the most significant prognostic factor(P=0.001).Conclusion The prognosis of uterine sarcoma is significantly related with menopause status , surgical staging and histological type.

Key words: uterine sarcoma, clinical feature, prognostic factors

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