Ⅲ期子宫内膜癌预后相关因素分析

Prognostic factors of stageⅢ endometrial carcinoma

目的探讨手术病理分期Ⅲ期子宫内膜癌的预后相关因素，以指导临床治疗。方法对102例手术病理分期为Ⅲ期的子宫内膜癌患者的临床资料进行回顾性分析。其中子宫内膜样腺癌71例，非子宫内膜样腺癌31例，单纯手术9例，术后辅助放疗42例，术后辅助化疗16例，术后辅助化放疗35例。结果经Cox回归分析，Ⅲ期子宫内膜癌的预后危险因素有病理学类型（P〈0.05）、治疗方法（P〈0．05）、脉管癌栓（P〈0．05）及年龄（P〈0．05）；其中Ⅲa期患者中单纯腹腔细胞学阳性与浆膜和（或）附件受累者的生存时间平均为74．4和53．8个月，差异有统计学意义（P〈0．05）。结论影响Ⅲ期子宫内膜癌的独立预后因素有病理类型、治疗方法、脉管癌栓及年龄。Ⅲa期子宫内膜癌中单纯腹腔细胞学阳性者的预后好于浆膜和（或）附件受累者。

Objective To investigate the prognostic factors of surgery-pathological stage Ⅲ endometrial cancer. Method The clinical data of 102 patients with stage Ⅲ endometrial cancer, aged 54. 9 （27 -79）, 71 with endometrioid adenocarcinoma, 31 with non-endometrioid adenocarcinoma , 9 undergoing simple surgical treatment, and 42 receiving radiation, 16 receiving chemotherapy, and 35 receiving chemo- radiation after surgery, were analyzed retrospectively. Follow-up was conducted for 56 （3 -192） months. Results Cox risk model analysis showed that the risk factors for the prognosis of stage Ⅲ endometrial cancer were pathological types, method of treatment, vascular thrombosis , and age （ all P 〈 0. 05 ）. The average survival time of stage m a endometrial cancer patients purely positive in peritoneal cytology was 74. 4 months, significantly longer than that of the patients with serosa and/or annex involvement （53.8 months,P 〈 0. 05）. Conclusion The independent prognostic factors of stage Ⅲ endometrial cancer are pathological type, method of treatment, vascular thrombosis, and age. The patients with , the prognosis of stage Ⅲ a endometrial cancer simply positive in peritoneal cytology is better than that with serous and/or annex involvement.