早期子宫内膜癌盆腔淋巴结切除的意义探讨

发布时间：2018-03-26 21:17

本文选题：子宫内膜癌　切入点：盆腔淋巴结转移　出处：《中国妇产科临床杂志》2015年02期

【摘要】：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。
[Abstract]:Objective to investigate the early endometrial cancer patients with pelvic lymph node metastasis, and prognostic factors. Methods from January 2006 to March 2011 in Peking Union Medical College Hospital after initial treatment, comprehensive surgical staging, clinical data of 263 cases of early endometrial cancer patients with lesions confined to the uterus were retrospectively analyzed. Results of the 263 patients, 21 cases of pelvic cavity the metastasis rate of lymph node metastasis, 7.98%. univariate analysis showed that tumor differentiation, depth of myometrial invasion than 1/2, non uterine endometrioid carcinoma, lymph vascular space involvement (LVSI), serum CA125 or 35U/L is a risk factor for endometrial cancer metastasis of pelvic lymph node early. Multivariate analysis showed that only the deep muscular layer the invasion and tumor differentiation is low, independent risk factors for endometrial cancer metastasis of pelvic lymph node. Early lymph node metastasis group and non metastasis group 3 years disease-free survival rates were 66.7% (14/21) And 99.2% (240/242), the difference between the two groups was statistically significant (P=0.000). Conclusion the probability of early endometrial carcinoma with pelvic lymph node metastasis is low, deep muscle invasion and low differentiation in the tumor are independent factors of pelvic lymph node metastasis.

【作者单位】：北京市第六医院妇产科;中国医学科学院
【基金】：国家科技支撑计划,妇科疾病现代治疗规范化研究(2008BAI57B00)
【分类号】：R737.33

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