| Objective:To explore the clinical characteristic,diagnosis and treatment of uterine papillary serous carcinoma,so as to improve the knowledge of the disease in diagnosis and treatment.Methods:By retrosepective investigating,the complete clinical data of 51 cases with UPSC(Uterine papillary serous carcinoma)who treated in Dalian Maternity Hospital from June 2011 to June 2016,analysis of his clinical manifestation,auxiliary examination results,treatment,operation's conditions,intraoperative and postoperative pathological examination results,postoperative recovery,follow-up treatment.Results:1.The average age of onset was 61±6.43 years in these 51 patients who were diagnosed by UPSC,the average menopausal age is 51.60±2.88 years,premenopausal patients were 4 cases(7.84%);the remaining 47 patients were postmenopausal(92.16%),UPSC has a high incidence in postmenopausal women.2.51 patients with positive symptoms,the major symptom was vaginal bleeding(68.00%),abnormal vaginal discharge(bloody secretions or rice water secretions)was 6 cases(12.00%),found that pelvic mass in 3 cases(6.00%),5 cases of abdominal pain(10.00%),2 cases of abdominal distension(4.00%).1 patient had no obvious discomfort.The main clinical manifestations of UPSC are abnormal vaginal bleeding,no specific clinical manifestations,when we meet a patient who have the abnormal vaginal bleeding in postmenopausal women,we must take more attention to it and make further examination to identify.3.There are 13 patients without preoperative complications and38 cases of patients with past medical history(74.51%),18 cases(the total number of35.29% patients)with the history of hypertension which was the most,15 cases of diabetes history(29.41%),2 cases of breast cancer operation(3.92%),7 cases of endometrial polyps(13.73%),4 cases of cervical polyp(7.84%),26 cases of uterine leiomyoma(50.98%),3 cases with a family history(5.88%),respectively is mother died of liver cancer,sister's history of cervical cancer,mother's history of breast cancer.There are 16 cases whose BMI were more than 28 kg/m2,accounted for 31.37% of the total number(16/51),the pathogenic factors of the disease is not clear.4.For lack of specificity of auxiliary examination,imaging examination in the diagnosis of the disease have implications,but there were no diagnosis significance?There were 21 cases increased CA125 values(? 35.00 U/ml),accounting for 41.18%,and with advanced pathological stage accounted for 76.19%(16/21).CA125 < 35.00U/ml in patients with advanced pathological stage accounted for 23.33%(7/30),comparison of the two,there is ?2=10.08,P<0.01,and the differences are highly statistically significant,CA125 in the diagnosis of UPSC has prompted value.In this study,23 cases of curettage under hysteroscopy surgery,total positive pathologic diagnostic rate was 37.26%(19/51),and the rest of the 28 patients curettage surgery,the total positive pathologic diagnostic rate was 11.77%(6/51).In contrast,the diagnostic accuracy of hysteroscopy assisted curettage was better than that of conventional curettage,which was significant in preoperative diagnosis.5.51 patients were all performed surgical treatment,including16 cases of postoperative line of paclitaxel and carboplatin combination therapy.The effective treatment of UPSC is still the surgical treatment.For the effect of radiation and chemotherapy,there is no clear evaluation.Conclusion:1.Endometrial serous adenocarcinoma mostly occurs in postmenopausal women.Its clinical symptoms are nonspecific,and postmenopausal bleeding is most common.2.The diagnosis of endometrial serous adenocarcinoma with pathological examination as the gold standard,the accuracy of hysteroscopic curettage is higher than that of the classical segmental curettage.3.In the examination of endometrial serous adenocarcinoma,CA125 is of significance in judging the staging of the disease.4.The main treatment of uterine papillary serous carcinoma is surgery,surgical operation should be a standard surgical staging(similar to ovarian serous papillary carcinoma cytoreductive surgery). |
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