Carcinoma of the endometrium: I. A clinicopathologic study of clear‐cell carcinoma and secretory carcinoma
Carcinoma of the endometrium: I. A clinicopathologic study of clear‐cell carcinoma and secretory carcinoma
复制标题
子宫内膜癌：一、透明细胞癌和分泌性癌的临床病理学研究
作者：
W. Christopherson;R. C. Alberhasky;P. Connelly
在1224例子宫内膜癌的病理回顾中，1023例被证实为子宫内膜癌。56例（5.5%）为透明细胞腺癌（CCE）。15例“分泌型癌”（SCE）进行了比较。对55例CCE患者和所有SCE患者随访至少5年或直至死亡。在CCE患者中，只有19名幸存者。五年后，没有一个幸存者死于疾病。在15例SCE患者中，13例存活了5年，尽管另外2例患者在5.4年和7年时死于疾病复发。所有CCE幸存者在诊断时均为I期患者。所有患者均为绝经后，中位年龄为67岁，而SCE患者为58岁。与SCE不同，CCE的形态在随后的子宫切除标本、复发性疾病和转移灶中得以保留。CCE在黑人女性中更常见，5年生存率仅为12.5%，而白色女性为39.1%。与一般的子宫内膜癌相反，大多数治疗失败的妇女死于疾病。在23年的研究期间，相对频率没有增加。诊断时的年龄似乎是一个重要的决定因素。预后也与疾病分期和肌层浸润深度密切相关。它与治疗方法的相关程度较低，与组织学模式或细胞分化程度的相关性较差：然而，基本上所有肿瘤都被认为是低分化的。最后，在64%的CCE女性中发现了透明质样、PAS阳性、抗凝血酶小体形式的组织学组织标志物。
In a pathologic review of 1224 cases of endometrial carcinoma, 1023 were confirmed cases of endometrial carcinoma. Fifty‐six (5.5%) were clear‐cell adenocarcinoma (CCE). Fifteen cases of “secretory carcinoma” (SCE) were examined for comparison. Fifty‐five patients with CCE and all with SCE were followed for at least five years or until death. There were only 19 survivors among those with CCE. No five‐year survivor subsequently died of disease. Of the 15 patients with SCE, 13 survived for five years although two additional patients died of recurrent disease at 5.4 and seven years. All survivors of CCE were Stage I patients at the time of diagnosis. All were postmenopausal, and had a median age of 67 years compared with 58 years for patients with SCE. Unlike SCE, the morphology of CCE was preserved in the subsequent hysterectomy specimen, in the recurrent disease, and in the metastases. CCE was proportionately more common in black women and the five‐year survival was only 12.5% as compared with 39.1% for white women. In contrast to endometrial carcinoma in general, most women who failed treatment died of disease. There was no increase in the relative frequency over the 23‐year time period of the study. Age at time of diagnosis seemed to be an important prognosticator. Prognosis also correlated well with stage of disease and depth of myometrial invasion. It correlated to a somewhat lesser extent with the method of treatment and had a poor correlation with the histologic pattern or degree of cellular differentiation: however, essentially all tumors were considered to be poorly differentiated. Finally, a histologic tissue marker in the form of hyalin‐like, PAS‐positive, diastase‐resistant bodies was found in the 64% of the women with CCE.