系统淋巴结切除在子宫内膜癌治疗中的临床意义探讨

发布时间：2019-01-05 14:55

【摘要】：目的:探讨子宫内膜癌患者在行系统(盆腔加腹主动脉旁)淋巴结切除的临床意义,以提高子宫内膜癌的疗效。方法:收集我院在2007年4月至2012年3月行系统淋巴结切除,并经病理检查确诊为子宫内膜癌的患者91例,分析其术中术后情况、腹主动脉旁淋巴结转移的影响因素及与生存率的关系。结果:91例患者中29例出现淋巴结转移,转移率为31.9%,其中盆腔淋巴结转移20例(22.0%),腹主动脉旁淋巴结转移23例(25.3%)。发生术中并发症6例(6.6%),术后并发症8例(8.8%)。多因素分析显示,非子宫内膜样癌、低分化(G3)、子宫肌层浸润深度1/2、盆腔淋巴结转移是腹主动脉旁淋巴结转移的独立危险因素。腹主动脉旁淋巴结转移患者的累积生存率(36.9%)明显低于无淋巴结转移患者累积生存率(91.9%),差异有统计学意义(P0.05)。结论:系统淋巴结切除对提高子宫内膜癌的疗效非常重要,且安全可行。
[Abstract]:Objective: to evaluate the clinical significance of systemic lymphadenectomy in patients with endometrial carcinoma. Methods: from April 2007 to March 2012, 91 patients with endometrial carcinoma were treated with systemic lymphadenectomy and confirmed by pathological examination, and their intraoperative and postoperative conditions were analyzed. Influencing factors of lymph node metastasis and its relationship with survival rate. Results: there were 29 cases of lymph node metastasis in 91 cases (31.9%), including 20 cases (22.0%) of pelvic lymph node metastasis and 23 cases (25.3%) of para-aortic lymph node metastasis. Intraoperative complications occurred in 6 cases (6.6%) and postoperative complications in 8 cases (8.8%). Multivariate analysis showed that non-endometrial carcinoma, low differentiation (G3), myometrium invasion depth of 1 / 2, pelvic lymph node metastasis is an independent risk factor for lymph node metastasis of abdominal aorta. The cumulative survival rate (36.9%) in patients with para-aortic lymph node metastasis was significantly lower than that in patients without lymph node metastasis (91.9%). The difference was statistically significant (P0.05). Conclusion: systematic lymphadenectomy is very important and safe in improving the efficacy of endometrial carcinoma.
【作者单位】：广西医科大学附属肿瘤医院;
【分类号】：R737.33

【共引文献】