摘要
目的:探讨影响子宫内膜癌淋巴结转移的相关因素,为制定手术方案提供依据。方法:收集经病理学证实的268例子宫内膜癌患者的临床病理资料并进行回顾性分析。根据患者淋巴结转移情况分为淋巴结转移阳性组和阴性组,分析2组肌层浸润、病理类型、宫旁受累情况、分化程度、年龄、腹腔细胞学结果及血清CA125水平的异同,并对上述指标与淋巴结转移之间的关系进行分析。结果:268例子宫内膜癌的淋巴结转移率为10.07%(27/268),主要转移至髂外淋巴结和闭孔淋巴结(占81.48%),腹主动脉旁淋巴结转移率为9.68%(6/62)。淋巴结转移率在深肌层浸润、非内膜样癌、中分化和低分化内膜样癌、累及宫颈或宫旁组织、血清CA125水平升高及年龄≥60岁的患者均分别显著高于无肌层和浅肌层浸润、子宫内膜样癌、高分化内膜样癌、仅限于宫腔内、血清CA125水平正常及年龄<60岁的患者(均P<0.01),而腹腔细胞学阳性与阴性者淋巴结转移率差异无统计学意义。多因素分析结果表明内膜样癌分化程度、肌层浸润和血清CA125水平是淋巴结转移的影响因素(均P<0.05)。结论:深肌层浸润、中低分化子宫内膜样癌和较高的血清CA125水平可作为淋巴结转移的高危因素。
Objective： To investigate the related clinical and pathological factors of lymph node metastasis in patients with endometrial carcinoma. Methods： A total of 268 patients with histological confirmed endometrial carcinoma were selected and retrospectively analysed. Patients were divided into two groups on the basis of positive or negative lymph nodes metastasis. The differences of the following parameters were compared between two groups, including depth of myometrial invasion, pathological type, para-uterus invasion, differential degree of endometrioid carcinoma, age, the result of abdominal cytology and serum CA125 level. Simultaneously, the correlation between the above parameters and lymph node metastasis were analyzed. Results： The lymph node metastasis rate was 10.07% （27/268） in 268 patients. The external iliac and obturator lymph nodes were the preferred sites, which took up about 81.48%. The abdominal aorta lymph node metastasis rate was 9.68% （6/62）. The metastasis rates were significantly higher in patients with deep myometrial invasion, non- endometrioid adenocareinoma, middle and poorly differentiated tumor, para-uterus invasion, higher abnormal serum CA125 level and age ≥60 than those of patients with non or superficial myometrial invasion, endometrioid adenocarcinoma, well differentiated tumor, without para-uterus invasion, normal serum CA125 level and age〈60 （P 〈 0.01 for all）, respectively. There was no significant difference in the lymph node metastasis rate between patients with positive and negative abdominal cytology detection. The logistic regression analysis showed that the degree of endometrioid adenocarcinoma differentiation, myometrial invasion and serum CA125 level were correlated with lymph node metastasis. Conclusion： The high-risk factors of lymph node metastasis were deep myometrial invasion, middle and poorly differentiated tumor and elevated serum CA125 level in patients with endometrial cancer.
出处
《天津医药》
CAS
北大核心
2012年第10期998-1001,共4页
Tianjin Medical Journal
