Minimal uterine serous carcinoma - Diagnosis and clinicopathologic correlation
Minimal uterine serous carcinoma - Diagnosis and clinicopathologic correlation
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DOI：
10.1097/00000478-200006000-00004
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发表时间：
2000-06-01
影响因子：
5.6
通讯作者：
Sherman, ME
中科院分区：
文献类型：
--
作者：
Wheeler, DT;Bell, KA;Sherman, ME
子宫浆液性癌（USC）缺乏肌层浸润，包括其假定的前体病变子宫内膜上皮内癌（EIC）的临床病理特征尚未得到广泛研究。一些USCs即使没有明显的肌层侵犯也可能是致命的，而另一些USCs可能仅通过手术治愈。因此，作者研究了8例单纯EIC（未发现浸润）和13例浸润仅限于子宫内膜间质的浅表浆液性癌（SSC），以阐明这些病变的行为。该综述表明，评估预后的最重要特征是就诊时是否存在宫外疾病。14例EIC或SSC局限于子宫（I期或IIA期）的患者中有13例（93%）无疾病，1例在52个月时死于不相关原因，而7例子宫外疾病（即使仅为显微镜检查）的女性要么死于疾病，要么因复发而存活。因此，EIC或SSC患者必须：在子宫切除术时进行细致的手术分期。由于EIC和SSC很难根据间质浸润的鉴别来区分，而且这些病变有着独特的临床表现，作者认为EIC和SSC小于或等于1 cm为“微小子宫浆液性癌”。"
The clinicopathologic features of uterine serous carcinoma (USC) lacking myometrial invasion, including its putative precursor lesion endometrial intraepithelial carcinoma (EIC), have not been studied extensively. Some USCs may prove fatal even when myometrial invasion is apparently absent, whereas others may be cured with surgery alone. Accordingly, the authors studied eight cases of pure EIC (no invasion identified) and 13 superficial serous carcinomas (SSCs) in which invasion was limited to the endometrial stroma to clarify the behavior of these lesions. The review demonstrated that the most important feature in assessing prognosis is the presence or absence of extrauterine disease at presentation. Thirteen of 14 patients (93%) with EIC or SSC confined to the uterus (stage I or IIA) were disease free and one was dead of unrelated causes at 52 months, whereas seven women who presented with extrauterine disease, even if only microscopic, were either dead of disease or alive with recurrences. Accordingly, patients with EIC or SSC must: undergo meticulous surgical staging at the time of hysterectomy. Because the distinction between EIC and SSC based on the identification of stromal invasion is difficult and these lesions share a unique pattern of clinical behavior, the authors regard EIC and SSC measuring 1 cm or less as "minimal uterine serous carcinoma."