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目的 探讨盆腔淋巴结清扫术 (清扫术 )对子宫内膜癌治疗的作用。方法 分析行清扫术者 10 4例 ,分别比较各种临床病理因素的盆腔淋巴结转移发生率 ,淋巴结行清扫术与非清扫术的 5年生存率。结果 临床Ⅰ期子宫内膜癌患者的盆腔淋巴结转移率为 4.4%。深肌层浸润及低分化癌(G3 )的盆腔淋巴结转移率升高 ,分别为 37.3%及 37.8%。临床Ⅰ、Ⅱ期患者盆腔淋巴结转移与非转移的 5年生存率分别为 38.9%及 74.2 % ,差异有显著性 (P <0 .0 0 5 )。病理Ⅰ、Ⅱ期行淋巴结清扫术与非淋巴结清扫术患者的 5年生存率分别为 73.1%及 82 .9% ,差异无显著性 (P >0 .0 5 )。结论 盆腔淋巴结转移是子宫内膜癌患者的重要预后因素 ,淋巴结清扫术本身不能改善早期患者的预后。Ⅰ期低危者盆腔淋巴结转移率甚低 ,不需施行清扫术。
Objective To investigate the effect of pelvic lymphadenectomy (dissection) on the treatment of endometrial cancer. Methods A total of 104 patients undergoing dissection were analyzed. The incidences of pelvic lymph node metastases, 5-year survival rates of lymph node dissection and non-dissection were compared among various clinical and pathological factors. Results The clinical stage Ⅰ endometrial cancer patients had a pelvic lymph node metastasis rate of 4.4%. Deep myometrial invasion and poorly differentiated carcinoma (G3) pelvic lymph node metastasis rates were 37.3% and 37.8%. The 5-year survival rates of patients with stage Ⅰ and Ⅱ pelvic lymph node metastasis and non-metastasis were 38.9% and 74.2%, respectively, with significant difference (P <0.05). The 5-year survival rates of patients with pathological stage I and II with lymph node dissection and non-lymph node dissection were 73.1% and 82.9% respectively, with no significant difference (P> 0.05). Conclusions Pelvic lymph node metastasis is an important prognostic factor in patients with endometrial cancer. Lymph node dissection itself can not improve the prognosis of patients with early stage. Stage Ⅰ low risk of pelvic lymph node metastasis rate is very low, no need for implementation of dissection.