子宮体癌の臨床
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概要
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A. Statistical analysis of the forty-nine cases of carcinoma of corpus uteri treated at the Department of Obstetrics and Gynecology, School of Medicine, Chiba University for a period of twenty years (from January, 1932 to December, 1951) has revealed the following results: 1. The cases of carcinoma of corpus uteri accounted for 2.23 % of all the cases of cancer of the uterus. Generally speaking, incidence of carcinoma of corpus uteri is lower in Japan than in Europe and America. 2. Carcinoma of corpus uteri occurred most frequently at fifties, the average age of incidence being 50.0. 3. Nulliparous accounted for 26.5 % of the patients with carcinoma of corpus uteri, and many of those who had any experience of delivery developed new growths considerably long time after the last delivery. These facts would indicate that continuation of non-pregnancy might be related in some way to the development of the new growth. 4. Cessation of menstruation tended to be delayed beyond normal ages' in patients with carcinoma of corpus uteri, occurring at the age of 49.4 on an average. 5. Of all the symptoms and signs manifested by the patients with carcinoma of corpus uteri, abnormal bleeding was most frequent (93.8 %), followed by pain (42.8 %) and genital discharge (30.6 %) in the indicated order. Patients complaining of pain were comparatively large in number. It could not, however, be regarded as a characteristic symptom of the new growth, for its nature and location varied with the different patients. The so-called Simpson's symptom has not been manifested. 6. The uteri of many patients with carcinoma of corpus were enlarged. They were hard (49.0 %), but this would not be a sign indicative of existence of new growths. 7. In 53.1 % of the patients with carcinoma of corpus uteri, exploratory curetting of the uterus was performed, and the new growth was histologically confirmed. Myoma of the uterus is the disease which should first of all be taken into consideration in differential diagnosis of carcinoma of corpus uteri. 8. Nearly all the patients with carcinoma of corpus uteri were treated surgically, receiving after-irradiation. The five-year cure rate was 52.1 %. E. Examinations of histologic specimens and estimation of urine estrogen levels have revealed the following results: 1. Histologically, the patients with adenocarcinoma were overwhelmingly numerous, accounting for 85.7 % of all the cases under review. 2. Nearly all the patients after climacteric showed the formation of follicular cyst and corpus luteum cyst in the ovaries. This would indicate that estrogen was still secreted, however small the amount might be. 3. Urine estrogen levels in six patients after menopause were in the range 90-520 γ/day, which were not especially high. 4. The above findings would indicate that estrogen is not an important factor in the development of carcinoma of corpus uteri.
- 千葉大学の論文