臨床婦人科産科61巻2号

2007年02月発行

今月の臨床 子宮体癌の最新知見─専門医のために

子宮体癌の発癌機構研究のトピックス

著者： 塩沢丹里¹ 小西郁生¹

所属機関： ¹信州大学医学部産婦人科学教室

ページ範囲：P.159 - P.167

はじめに

　子宮内膜癌は近年わが国で明らかな増加傾向を示すことから，その発癌機構の解明が待たれる腫瘍の1つである．子宮体癌は臨床病理学的におおむね2つのタイプに分類できるといわれている^{1, 2）}．タイプ1の内膜癌はエストロゲン刺激，肥満，不妊症などを背景とし，子宮内膜増殖症を経て発生する高分化型の類内膜腺癌で，閉経前あるいは閉経早期の比較的若年に多く，筋層浸潤は浅くエストロゲン受容体（ER）やプロゲステロン受容体（PR）が陽性で比較的予後良好である．これに対してタイプ2の内膜癌は，比較的高齢の女性にエストロゲン非依存性に萎縮内膜から増殖症を経由せずに直接発症するタイプで，組織型としては漿液性腺癌，明細胞腺癌や低分化型類内膜腺癌が多く予後不良であるといわれている．また，近年の分子生物学的検討の結果でもその2つのタイプにおける遺伝子変異は異なる傾向を示している．

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