Endometrial

carcinoma
一、 FEATURE

A malignant epithelial tumor that occurs

in the endometrium
One of the three major malignant tumors
in female genital tract
二、 Pathogeny
I type:Estrogen dependent
II type ： Estrogen independent type
Have no source of estrogen stimulation
of endometrium.
Poor prognosis
三、 Microscope ：
Five histological subtypes ：
Endometrioid adenocarcinoma:
I grade ： Highly differentiated adenocarcinoma

II grade ： Middle differentiated adenocarcinoma

III grade ： Low differentiated adenocarcinoma

Clear cell carcinoma 透明细胞癌： High degree of malignan

cy and early metastasis

Serous adenocarcinoma 浆液性腺癌： High degree of mali

gnancy
 五、 Transfer pathway

Lymphatic metastasis ：
Main route of transfer,the pathway of metastasis is
related to the site of cancer growth.
metastasis:
Advanced ,blood transfer to lung, liver, bone, etc
 Surgical pathologic staging （ FIGO ， 2009 ）
Stage Tumor rang 肿瘤范围
Stage I Tumor limited to the uterine body 肿瘤局限于子宫体

Ia Invasion to less than half of the myometrium 肿瘤浸润深度＜ 1/2 肌层

Ib Invasion equal to or more than half of the myometrium 肿瘤浸润深度≥ 1/2 肌

 层

Stage II Tumor invasion of the uterine cervix, but there is no spread of the uterus i
n vitro 肿瘤侵犯宫颈间质，但无宫体外蔓延
Stage Tumor invasion of local and / or regional diffusion 肿瘤局部和（或）区域扩散
III
IIIa Tumor invades the serosa of the corpusuteri and/or adnexae 肿瘤累及浆膜层
和（或）附件

IIIb Vaginal and / or para uterine involvement 阴道和（或）宫旁受累

IIIc Metastases to pelvic and/or para-aortic lymph nodes

（ IIIC1 、 IIIC2 ）盆腔和（或）腹主动脉旁淋巴结转移（ IIIC1 、 IIIC2 ）
Stage IV Tumor invades bladder and / or mucosa and / or distant metastasis.

Ⅳa Tumor invasion of bladder and/or rectal mucosa

Ⅳb Distant metastases, including intra-abdominal metastasis and/or inguinal l

六、 Clinical Features

Symptoms Diagnosis
*Vaginal bleeding Fractional curettage
*Vaginal discharge B-mode ultrasonography
Hysteroscopy
*pain MRI 、 CT 、 CA125
七、 Differential Diagnosis
 Vaginal bleeding during menopause transiti
on
 Senile vaginitis

 Submucous myoma of the uterus or endom

etrium
 Primary fallopian tube carcinoma

 Senile endometritis with intrauterine purule

nt
 Uterine cervix carcinoma and uterine sarco
ma
八、 Treatment
 Operation

 Radiotherapy

 chemotherapy
九、 Follow up
 Follow-up time ：
The patients were followed up once ever
y 3 months after 2~3 years, once every 6
months after 3 years, and once a year aft
er 5 years.
Thank you