子宫内膜和卵巢原发性双癌1例并83例文献复习.docVIP

子宫内膜和卵巢原发性双癌1例并83例文献复习 　　【摘要】 目的：探讨子宫内膜和卵巢原发性双癌的临床表现、病理特征、治疗方法及预后。方法：报道子宫内膜和卵巢原发性双癌1例，并对国内近10年来已报道的83例进行文献复习。结果：84例患者临床表现主要为盆腔包块（70.2%，59/84），阴道出血（61.9%，52/84），腹痛、腹胀（34.5%，29/84）。无一例术前确诊。病理报告子宫内膜和卵巢均为子宫内膜样癌者52例（61.9%），两种癌分期均为Ⅰ期者50例（59.5%）。所有患者均接受手术治疗，72例患者术后接受化疗，14例接受放疗。84例中有3例失访，随访5年以上者55例，其中死亡13例，死亡率为23.6%（13/55），1、3、5年生存率分别为89.1%（49/55）、81.8%（45/55）、76.4%（42/55）。结论：子宫内膜和卵巢原发性双癌术前诊断困难，以内膜和卵巢同为子宫内膜样癌为主要病理类型，发现时多为Ⅰ期，以手术结合术后化疗为主要治疗方式，预后良好。 　　【关键词】 子宫内膜癌； 卵巢癌； 原发性双癌 　　One Case Report and 83 Cases Literature Review of Synchronous Primary Cancers of the Endometrium and Ovary/NI Qin，MI Xin，ZHANG Feng-ge，et al.//Medical Innovation of China，2015，12（23）：122-125 　　【Abstract】 Objective：To investigate the clinical manifestation，pathological characteristics，treatment and prognosis of synchronous primary cancers of the endometrium and ovary.Method：One case of synchronous primary cancers of the endometrium and ovary was reported and the literatures of 83 cases had been reported in the past 10 years in domestic were reviewed.Result：The main clinical manifestations of 84 patients included pelvic mass in 59 cases（70.2%），vaginal bleeding in 52 cases（61.9%），abdominal pain and distention in 29 cases（34.5%）.None was diagnosed correctly preoperatively.61.9%（52/84） of patients were the same histological subtype，which was endometrioid adenocarcinoma.59.5%（50/84） of patients with two cancers were both at stage Ⅰ.All the patients underwent operation.72 cases received adjuvant chemotherapy.14 cases received adjuvant radiation.In 84 cases，3 patients were lost，55 cases were followed up for 5 years or more，23.6%（13/55） of patients died.The 1，3 and 5-year survival rates were 89.1%（49/55），81.8%（45/55），76.4%（42/55），respectively.Conclusion：Synchronous primary cancers of the endometrium and ovary is difficult to be diagnosed preoperatively.The main pathological type is endometrial carcinoma of both the endometrium and ovary.Most of the patients were detected at stage Ⅰ.The main treatment is s