【摘要】 目的：通过２８例子宫恶性苗勒氏管混合瘤的临床资料，探讨相关因素及适当的治疗方法。方法：回顾性分析１９７２年１月－１９９７年 １２月我院收治的 ２８例子宫恶性苗勒氏管混合瘤的临床资料。结果：５年总生存率３５．７％。癌肉瘤 ５年生存率４１．７％，中胚叶混合瘤５年生存率３１．３０（Ｐ＞０．０５）。Ⅰ、Ⅱ期患者５年生存率５６．３％，明显高于Ⅲ、Ⅳ期的９．１％（Ｐ＜０．０１）。子宫体积大于妊娠 １０周者， ５年生存率 ０％，小于 １０周者， ５年生存率 ５３ ．０％（ Ｐ＜ ０． ０１）。已绝经组 ５年生存率 ３８ ．９％，高于未绝经组３０％（Ｐ＞０．０５）。应用 Ｃｏｘ模型比较术后加放疗或化疗对生存率的影响，放疗组明显高于化疗组，Ｐ＜０．０１。表明化疗可提高患者生存率。结论：子宫恶性苗勒氏管混合瘤生存率与手术病理分期、子宫大小有密切关系，与病理类型、是否绝经无明显关系，术后辅以放疗对提高生存率有帮助。更多还原

【Abstract】 Objective: To evaluate the prognostic factors and treatment methods of 28 uterine malignant mullerian duct mixed tumor Materials and Methods: 28 cases of the uterine malignant mullerian duct mixed tumor were collected for this retrospective study. Of the 28 cases, there were 12 carcinosarcomas, 16 malignant mesodormal mixed tumors. 13 cases were in stage I, 4 stage II, 9 stage III and 2 stage IV. 4 cases were treated by surgery alone, 5 by surgery combined with radiation therapy, 7 by surgery plus chemotherapy, 10 by surgery plus radiation therapy and chemotherapy, 2 by radiation therapy plus chemotherapy. Results: The overall 5 - year survival rate was 35. 7 %, 41. 7 % carcinosarcomas and 31. 1 % in malignant mesodermal mixed tumors respectively (P >0. 05). The 5 - years survival rates of lesions limited to the uterus (stage I + II ), and that of pelvic cavity invasion (stage III ) with distant metastases (stage IV ) were 56. 3 % and 9. 1 % respectively (P <0. 01). When the uterus was smaller than a pregnant uterus of 10 weeks, the 5 - year survival rates rate was 53. 0 % while that of larger than a 10 weeks pregnant uterus was 0 % (P < 0. 01 ). 5 - Year survival for premenopausals and postmenopausals were 30. 0 % and 38. 9 % respectively (P > 0. 05). Conclusion: The prognosis of uterine malignant mullerian duct mixed tumor is significantly associated with surgicopathological stage and uterine size. It is not significantly correlated with histologic type and pre - or postmenopausal status. A combination of surgery and radiotherapy can be helpful to enhance the survivals.更多还原