臨床婦人科産科64巻12号

2010年12月発行

今月の臨床 子宮体癌診療の動向─これだけは知っておきたい

子宮体癌の診断と治療

6．子宮体癌の特殊な組織型への対応―明細胞癌，漿液性癌，癌肉腫

著者： 平川誠¹ 長井裕¹ 青木陽一¹

所属機関： ¹琉球大学大学院医学研究科環境長寿医科学女性・生殖医学講座

ページ範囲：P.1656 - P.1661

文献概要

はじめに

　子宮体癌には臨床病理学的に異なる2つのタイプが存在し，1つはエストロゲン依存性の子宮体癌でtype 1と呼ばれ，閉経期もしくはその前の比較的若年の女性に発症する．これに対して，エストロゲンには依存せず，主に閉経後の高齢者に発症するのがType 2であり，類内膜腺癌Grade 3，漿液性腺癌（uterine papillary serous adenocarcinoma : UPSC），明細胞腺癌（uteine clear cell adenocarcinoma : UCCC）をその組織型とし，子宮体癌全体としての頻度は低いがType1と比較して低分化型であり，体部筋層浸潤が深く，リンパ節転移も高率であり，その結果5年生存率は30％以下ときわめて予後不良といわれている（表1）．また子宮癌肉腫（uterine carcinosarcoma : CS）も子宮体部腫瘍では稀であり，予後不良な腫瘍である．本稿ではUPSC，UCCC，CSの臨床的特徴，治療法，ならびに予後について文献的考察を中心に述べたい．

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