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目的分析子宫内膜癌患者盆腔加腹主动脉旁淋巴结切除的临床意义。方法选取子宫内膜癌患者71例为研究对象,行盆腔加腹主动脉旁淋巴结切除术,分析患者术后临床特征,以及影响患者盆腔及腹主动脉旁淋巴结转移的危险因素。结果对盆腔及腹主动脉旁淋巴结患者行切除术后淋巴结转移率较低,分别为21.2%和23.9%,且患者术后并发症较少,仅为7例;线性回归分析提示,影响盆腔淋巴结转移的独立危险因素有肿瘤中低分化、深度肌层浸润、临床分期及脉管浸润,而影响腹主动脉旁淋巴结转移的独立危险有肿瘤低分化、非子宫内膜样癌、深度肌层浸润、盆腔淋巴结转移及淋巴管浸润;71例患者随访1年生存率为87.32%,且发生盆腔加腹主动脉旁淋巴结转移患者的生存率明显低于无淋巴结转移者。结论盆腔加腹主动脉旁淋巴结切除,有利于提高子宫内膜癌患者的临床治疗效果,而且安全性较高,值得临床推广应用。
Objective To analyze the clinical significance of pelvic and abdominal para-aortic lymph node dissection in patients with endometrial cancer. Methods Seventy-one patients with endometrial carcinoma were selected as the research object. The patients underwent pelvic and para-aortic lymph node dissection. The clinical features, the risk factors influencing pelvic and para-aortic lymph node metastasis were analyzed. Results The rate of lymph node metastasis after resection in patients with pelvic and para-aortic lymph nodes was lower (21.2% and 23.9%, respectively), and the number of postoperative complications was very low in only 7 patients. The linear regression analysis indicated that the pelvic lymph nodes The independent risk factors for metastasis were poorly differentiated tumor, deep myometrial invasion, clinical stage and vascular invasion. The independent risk of metastasis of para-aortic lymph nodes was poorly differentiated tumor, non-endometrioid carcinoma, deep myometrial invasion , Pelvic lymph node metastasis and lymphatic invasion. The one-year survival rate of 71 patients was 87.32%, and the survival rate of patients with pelvic and para-aortic lymph node metastasis was significantly lower than those without lymph node metastasis. Conclusions Pelvic and para-aortic lymph node resection is helpful to improve the clinical effect of endometrial cancer patients, and it is safe and worthy of clinical application.