子宫内膜癌卵巢转移危险因素及保留卵巢的可行性探讨

Approach of the Ovarian Metastasis and Ovarian Preservation in Patients with Endometrial Carcinoma

目的:探讨子宫内膜癌卵巢转移的高危因素及术中保留卵巢的可行性。方法:回顾性分析1999年1月至2003年12月在四川大学华西第二医院首诊并行手术治疗的388例子宫内膜癌患者的临床病理资料。结果:26例(6.7%)发生卵巢转移,其中15例(57.7%)为隐性转移。多因素分析预测子宫内膜癌卵巢转移的独立危险因素,按危险强度排列为盆腔淋巴结转移、宫颈侵犯、肌层浸润深度、病理分级;卵巢大小、腹腔内转移是卵巢隐性转移的独立危险因素。结论:子宫内膜癌患者保留卵巢应审慎,应警惕隐性卵巢转移发生的可能。

Objective： To approach the risk factors for ovarian metastasis and the feasibility of ovarian preservation in patients with endometrial carcinoma. Methods： The clinicopathological features and outcomes of endemetrial carcinoma patients who were diagnosed and treated from Jan 1999 to Dec 2003 in our hospital were retrospectively reviewed and analyzed. Results： Of the 388 cases reviewed, 26（6.7%） had ovarian metastasis, among which 57.7% had recessive metastasis. Factors predictive of ovarian metastasis on multivariate analysis in these patients were ranked according to risk intensity： pelvic lymph node metastasis, cervical involvement, the depth of myornetrial invasion, tumor grade. Size of the ovary and extrapelvic peritoneal metastasis were the independent risk factors of ovarian recessive metastasis on multivariate analysis. Conclusions： Deliberate attitude should be taken as to preserve the ovary or not. The potentiality of the ovarian recessive metastasis cannot be ignored.