低级别子宫内膜癌腹膜后淋巴结转移的相关因素及预后分析

发布时间：2018-04-26 15:30

  本文选题：子宫内膜肿瘤 + 淋巴转移　； 参考：《医学研究生学报》2015年07期

【摘要】：目的低级别子宫内膜癌患者淋巴结转移的特征以及淋巴结转移对患者预后的影响,目前还存在一些争议。文中旨在探讨低级别子宫内膜癌患者的淋巴结转移特征、高危因素及其对预后的影响,为制定手术方案提供参考依据。方法选取新疆医科大学附属肿瘤医院2006年1月1日至2011年1月1日收治的218例行腹膜后淋巴结清扫术的低级别子宫内膜癌患者,根据术后病理分析淋巴结转移特征,并根据长期随访结果分析淋巴结转移与患者生存期的关系。结果 1淋巴结转移特征:淋巴结转移率为16.97%(37/218),其中主要仅转移至髂外淋巴结和闭孔淋巴结者20例(54.05%),仅转移至腹主动脉旁淋巴结者6例(16.22%),同时转移至盆腔及腹主动脉旁淋巴结者11例(29.73%)。2低级别子宫内膜癌淋巴结转移影响因素分析结果显示:深肌层浸润(OR:5.21,95%CI:2.77~9.81)、脉管癌栓(OR:1.15,95%CI:1.02~1.30)、宫颈间质受累(OR:3.15,95%CI:1.12~8.35)及CA125升高(OR:3.46,95%CI:1.56~7.67)是淋巴结转移的影响因素(P0.05)。3低级别子宫内膜癌淋巴结转移的预后显示:有、无淋巴结转移的3年生存率分别为83.8%、95.0%;3年无瘤生存率分别为73.0%、90.1%,差异均有统计学意义(P0.05)。结论深肌层浸润、脉管癌栓、宫颈间质受累和血清CA125值较高的低级别子宫内膜癌患者易发生淋巴结转移,有淋巴结转移的患者预后较差。
[Abstract]:Objective the characteristics of lymph node metastasis in low grade endometrial carcinoma and the influence of lymph node metastasis on prognosis are still controversial. The purpose of this study was to investigate the characteristics of lymph node metastasis, high risk factors and their influence on prognosis in patients with low grade endometrial carcinoma. Methods 218 patients with low grade endometrial carcinoma treated by retroperitoneal lymph node dissection from January 2006 to January 1, 2011 in affiliated Cancer Hospital of Xinjiang Medical University were selected, and the characteristics of lymph node metastasis were analyzed according to postoperative pathology. The relationship between lymph node metastasis and survival time was analyzed according to long-term follow-up. Results 1 characteristics of lymph node metastasis: the lymph node metastasis rate was 16.97% 37 / 218g, of which only 20 cases were mainly transferred to external iliac lymph nodes and obturator lymph nodes, 6 cases to the lymph nodes adjacent to the abdominal aorta, and to pelvic and abdominal active metastasis. Analysis of influencing factors of lymph Node Metastasis in 11 cases of Peripheral lymph Node with low grade endometrial carcinoma. The results showed that the invasion of deep myometrium was OR 5.21 ~ 95 CI: 2.77 ~ 9.81%, OR: 1.15 ~ 95 CI: 1.02T 1.30, cervix interstitial involvement OR3.1595 CI1.128.35) and CA125 increased ORW 3.4695 CIW 1.566.7.67) were the influencing factors of lymph node metastasis. The prognosis of lymph node metastasis in other endometrial carcinoma is: yes, The 3-year survival rate of lymph node metastasis was 83.8% and that of tumor free group was 73.0% and 90.1%, respectively. The difference was statistically significant (P 0.05). Conclusion low grade endometrial carcinoma patients with deep muscle invasion, vascular tumor embolus, cervical interstitial involvement and high serum CA125 are prone to lymph node metastasis, and the prognosis of patients with lymph node metastasis is poor.
【作者单位】： 新疆医科大学附属肿瘤医院妇外五科;
【基金】：新疆医科大学“天山英才工程”项目(Y0231021)
【分类号】：R737.33
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本文编号：1806602