Clinical Analysis Of42Cases Of Uterine Papillary Serous

Objective: To investigate the clinical and pathological charaeteristics， the rational therapy and prognostic factors for the uterine papillary serous carcinoma(UPSC).Methods: Forty-two cases of UPSC were treated in our hospital between July2007and July2012.The clinico-pathological charaeteristics,treatment and prognosis were retrospeetively analyzed.Results:42cases of UPSC accounted for17.2%of carcinoma of uterine endometrium,their average age at diagnosis was66years.The positive rates ofCA125was44.4%，which were66.7%for stageⅢ-Ⅳ.The rate of diagnosis in pre-operation was33.3%of42cases. The early stage (stageⅠ-Ⅱ) accounted for61%，while late stage (stageⅢ-Ⅳ)accounted for39%.Thers was onlyone patient not take Surgical treatment. Pure UPSC were seen in83%,mixed were17%,43.9%were G3，49%invaded more than half myometrium，16patients underwent pelvic lymph node dissection,5patients with lymph node-positive, accounting for31%,11patients underwent omentum resection,5cases were found the foci transfer, accounting for45.4%.71%presented negative estrogen receptor,86%presented negative progesterone receptor,75%presented positive P53, ki-67index was in the range of20%-90%, mean:67±21%.10cases received postoperative adjuvant radiotherapy,12received postoperative adjuvant chemotherapy,5received postoperative adjuvant radiotherapy and chemotherapy，postoperative adjuvant chemotherapy seems to improve the prognosis(P=0.044).In analysis FIGO stages (P=0.00),was associated wi th prognosis.Conclusion:UPSC is a special pathological type of endometrial carcinoma with highly aggressive behaviors and highly malignant，most UPSC patients are in late stages at diagnosis. The diagnosis in pre-operation must rely on curettage, CA125, type-B ultrasonic and pathological immunohistochemistry can improve diagnosis rate. They often have poorly differentiated tumor cellsand have a propensity for deeply myometrial invasion，extra-uterine spread and distant metastases. Many Patients diagnosed as higher stage postoperatively than preoperative staging.They have a rather poor prognosis and a high rate of reeurrence and metastases. FIGO stages ociated with prognosis.Complete surgical staging and maximal reseetion should be recommended,and postoperative adjuvant chemotherapy seems to improve the prognosis.