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目的探讨早期子宫内膜癌患者盆腔淋巴结转移率、相关因素及预后。方法对2006年1月至2011年3月北京协和医院初治、经全面手术病理分期、病变局限于子宫体的263例早期子宫内膜癌患者的临床资料进行回顾性分析。结果 263例患者中,21例发生盆腔淋巴结转移,转移率为7.98%。单因素分析显示,肿瘤中低分化、肌层浸润深度≥1/2、非子宫内膜样癌、血管淋巴间隙受累(LVSI)、血清CA125≥35U/L是早期子宫内膜癌盆腔淋巴结转移的危险因素。多因素分析显示,仅深肌层浸润和肿瘤中、低分化是早期子宫内膜癌盆腔淋巴结转移的独立危险因素。淋巴结转移组和非转移组的3年无瘤生存率分别为66.7%(14/21)及99.2%(240/242),两组比较,差异有统计学意义(P=0.000)。结论早期子宫内膜癌合并盆腔淋巴结转移的概率低,深肌层浸润及肿瘤中、低分化是盆腔淋巴结转移的独立影响因素。
Objective To investigate the pelvic lymph node metastasis rate, related factors and prognosis in patients with early endometrial cancer. Methods The clinical data of 263 patients with early endometrial carcinoma who were initially treated at Peking Union Medical College Hospital from January 2006 to March 2011 after a comprehensive surgical and pathological staging with limited lesions in the uterus were retrospectively analyzed. Results Among 263 patients, 21 cases had pelvic lymph node metastasis with a rate of 7.98%. Univariate analysis showed that the poorly differentiated tumors, the depth of myometrial invasion≥1 / 2, the non-endometrioid carcinoma, the vascular lymphatic space involvement (LVSI), the serum CA125≥35U / L were the early stage of endometrial carcinoma with pelvic lymph node metastasis Risk factors. Multivariate analysis showed that deep myometrial infiltration and poorly differentiated tumors were the independent risk factors for pelvic lymph node metastasis of early endometrial cancer. The 3-year disease-free survival rates of lymph node metastasis and non-metastasis groups were 66.7% (14/21) and 99.2% (240/242), respectively. There was significant difference between the two groups (P = 0.000). Conclusion Early endometrial cancer with pelvic lymph node metastasis is low probability, deep myometrial invasion and poorly differentiated tumor are independent factors affecting pelvic lymph node metastasis.