UTERINE PAPILLARY SEROUS CARCINOMA - A HIGHLY MALIGNANT FORM OF ENDOMETRIAL ADENOCARCINOMA
UTERINE PAPILLARY SEROUS CARCINOMA - A HIGHLY MALIGNANT FORM OF ENDOMETRIAL ADENOCARCINOMA
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DOI：
10.1097/00000478-198203000-00002
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发表时间：
1982-01-01
影响因子：
5.6
通讯作者：
KEMPSON, R
中科院分区：
文献类型：
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作者：
HENDRICKSON, M;ROSS, J;KEMPSON, R
本文回顾了在美国斯坦福大学医院治疗的病理I期子宫腺癌256例，其中26例为子宫乳头状浆液性癌（UPSC），是一种与卵巢乳头状浆液性癌非常相似的具有临床侵袭性、形态独特的腺癌变体。这些病变很容易通过显微镜检查识别，典型特征是高度的细胞学发育不全和乳头状生长模式。淋巴管的浸润是一种常见的发现。病理I期UPSC患者复发率为50%(13/26)，是UPSC发病率预测复发率的5倍。I期UPSC患者的预后明显差于非乳头状II级或III级腺癌组（P < 0.0001）。在I期UPSC患者中，40%有深部肌层浸润，相比之下，所有其他组织学类型的腺癌患者中这一比例为12% （P = 0.001）。UPSC深度侵入子宫内膜的女性往往比那些更常见的子宫内膜样病变深度侵入的女性表现更差，复发率（仅手术后）分别为63%和30%。在7例初始失败部位在上腹部的I期体癌患者中，6例有UPSC。因此，UPSC与其卵巢对应物一样有向腹膜表面扩散的趋势。除了最初的26例I期患者的研究组外，还审查了34例更晚期的UPSC患者。其中26人随访，4人存活。在这些女性中，11例出现或复发腹部癌。UPSC是一种临床侵袭性肿瘤，应与其他类型的原发性子宫内膜腺癌区分开来。侵袭性UPSC的扩散方式与卵巢表面上皮癌相似，提示需要辅助上腹部和盆腔照射或有效化疗。
A review of 256 cases of pathologic Stage I uterine adenocarcinoma treated at Stanford University Hospital [California, USA] revealed 26 cases of uterine papillary serous carcinoma (UPSC), a clinically aggressive and morphologically distinct variant of adenocarcinoma which closely resembles ovarian papillary serous carcinoma. These lesions are easily recognized by microscopic examination and typically feature a high degree of cytologic anaplasia and a papillary growth pattern. Invasion of the lymphatics has been a frequent finding. The relapse rate among patients with pathologic Stage I UPSC was 50% (13/26), 5 times the rate which would have been predicted by the incidence of UPSC. Patients with Stage I UPSC fared significantly worse than the group of nonpapillary grade II or grade III adenocarcinomas (P < 0.0001). Of Stage I UPSC patients, 40% had deep myometrial invasion, as compared with 12% of those with all other histologic types of adenocarcinoma (P = 0.001). Women with UPSC deeply invading the myometrium tended to do worse than those with deeply invasive lesions of the more usual endometrioid type, as reflected by relapse rates (after surgery alone) of 63 and 30%, respectively. Of 7 Stage I corpus carcinoma patients whose initial site of failure was in the upper abdomen, 6 had UPSC. Thus, UPSC shares the tendency of its ovarian counterpart to spread over peritoneal surfaces. In addition to the original study group of 26 Stage I patients, 34 patients with more advanced stages of UPSC were also reviewed. Of these, 26 were followed and 4 survive. Of these women, 11 presented or relapsed with abdominal carcinomatosis. UPSC is a clinically aggressive neoplasm which should be distinguished from other types of primary endometrial adenocarcinoma. In cases of invasive UPSC the mode of spread, similar to that of ovarian surface epithelial carcinomas, suggests the need for adjuvant upper abdominal and pelvic irradiation or effective chemotherapy.