50例子宫内膜癌合并卵巢受累患者的临床病理特征分析

发布时间：2018-11-07 07:48

【摘要】：目的1.分析子宫内膜癌卵巢转移的危险因素并探讨术中保留卵巢的可行性。2.分析子宫内膜癌卵巢隐性转移的危险因素。3.对于子宫内膜癌卵巢转移患者的临床病理特征与子宫内膜及卵巢原发性双癌患者的临床病理特征进行对比分析,为临床鉴别诊断与治疗提供理论依据。材料方法回顾性分析自1985年1月至2016年1月在天津医科大学总医院收治的788例子宫内膜癌患者的临床病理资料,所有患者均不合并其他部位恶性肿瘤,术前均未进行放疗治疗、化疗以及激素治疗。其中包括50例内膜癌患者合并卵巢受累,50例患者包括41例子宫内膜癌卵巢转移患者和9例子宫内膜及卵巢原发性双癌患者。41例子宫内膜癌卵巢转移患者中,20例为显性转移,21例为隐性转移。本研究采用spss19.0进行统计学分析,子宫内膜癌卵巢转移及卵巢隐性转移的危险因素采用单因素及多因素logistic回归分析,p0.05差异有显著性;连续型变量描述采用平均值±标准差(?x±s)描述,子宫内膜及卵巢原发性双癌组与子宫内膜癌卵巢转移组之间的对比分析,当两组例数≥40时,采用四格表的x2检验计算结果,当两组例数40时,则采用Fisher确切概率法进行计算结果。两组间计量资料用t检验。检验水准α=0.05。结果1.子宫内膜癌卵巢转移的临床病理特征单因素回归分析显示输卵管浸润、病理类型及级别、子宫肌层浸润深度、宫旁组织浸润、盆腔淋巴结转移、宫颈浸润、血清CA125≥35U/m L、子宫浆膜浸润与内膜癌卵巢转移存在相关性(p0.05);多因素logistic回归分析显示输卵管浸润、宫旁浸润、血清CA125≥35U/m L是内膜癌卵巢转移的独立危险因素;2.子宫内膜癌卵巢隐性转移单因素回归分析示输卵管浸润、病理类型、子宫肌层浸润深度、病理级别、宫旁浸润、盆腔淋巴结转移、血清CA125≥35U/m L及腹水或腹腔冲洗液细胞学阳性与卵巢隐性转移存在相关性,多因素logistic回归分析未发现与隐性转移的相关危险因素;3.子宫内膜及卵巢原发性双癌组与子宫内膜癌卵巢转移组关于肿瘤级别、卵巢肿瘤的大小的因素差异有统计学意义(p0.05),子宫内膜及卵巢原发性双癌组相对于子宫内膜癌卵巢转移组,肿瘤级别较低,卵巢肿物直径较大。结论1.输卵管浸润、宫旁浸润及血清CA125≥35U/m L是子宫内膜癌卵巢转移的独立危险因素。2.输卵管浸润、病理类型、肌层浸润深度、病理级别、宫旁浸润、盆腔淋巴结转移、血清CA125≥35U/m L及腹水或腹腔冲洗液细胞学阳性与卵巢隐性转移存在相关性。3.子宫内膜及卵巢原发性双癌患者相对于子宫内膜癌卵巢转移患者的内膜病灶病理级别较低,卵巢肿瘤直径相对较大。
[Abstract]:Objective 1. To analyze the risk factors of ovarian metastasis in endometrial carcinoma and to explore the feasibility of ovarian preservation during operation. 2. To analyze the risk factors of ovarian recessive metastasis in endometrial carcinoma. The clinicopathological features of patients with ovarian metastasis from endometrial carcinoma were compared with those of patients with primary double carcinoma of endometrium and ovary, which provided a theoretical basis for clinical differential diagnosis and treatment. Methods from January 1985 to January 2016, 788 patients with endometrial carcinoma treated in the General Hospital of Tianjin Medical University were retrospectively analyzed. Chemotherapy and hormone therapy. These included 50 cases of endometrial carcinoma with ovarian involvement, 50 cases of endometrial carcinoma with ovarian metastasis and 9 cases of primary endometrial and ovarian double carcinoma. There were 20 cases of dominant metastasis and 21 cases of recessive metastasis. In this study, spss19.0 was used to analyze the risk factors of ovarian metastasis and recessive metastasis of endometrial carcinoma by univariate and multivariate logistic regression analysis. The mean 卤standard deviation (? x 卤s) was used to describe the continuous variable. The comparative analysis was made between the primary double carcinoma of endometrium and ovary and the ovarian metastasis of endometrial carcinoma, when the number of cases in the two groups was more than 40. The results are calculated by using the x2 test of the four-grid table, and when the number of the two groups of cases is 40, the exact probability method of Fisher is used to calculate the results. The metrological data between the two groups were tested by t test. The test level is 伪 = 0.05. Result 1. Single factor regression analysis showed fallopian tube invasion, pathological type and grade, depth of myometrium invasion, periuterine tissue infiltration, pelvic lymph node metastasis, cervix invasion, serum CA125 鈮，

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