子宫内膜癌宫颈间质浸润临床病理特征

Clinicopathologic features of endometrial carcinoma with cervical interstitial invasion

目的 :探讨子宫内膜癌宫颈间质浸润的临床病理特征。方法 :回顾性分析2012年1月—2012年12月具备完整病历资料的213例子宫内膜癌患者的临床病理资料,评估子宫内膜癌宫颈间质浸润相关危险因素。结果 :213例子宫内膜癌患者中,宫颈间质浸润71例(33.3%)。单因素分析发现,年龄、体质量指数、空腹血糖、血清总胆固醇、术后病理以及是否合并子宫肌瘤与宫颈间质浸润无明显相关性(P>0.05),而组织学分级、肌层浸润、病变范围以及是否存在脉管癌栓与宫颈间质浸润相关(P<0.05)。多因素分析结果显示,组织学分级和病变范围是子宫内膜癌宫颈间质浸润的独立危险因素。磁共振成像诊断子宫内膜癌宫颈间质浸润的敏感度、特异度和准确性均优于经阴道超声检查。结论 :组织学分级和病变范围是子宫内膜癌宫颈间质浸润的独立危险因素。在预测子宫内膜癌宫颈间质浸润方面,磁共振成像较经阴道超声检查更为可靠。

Objective： To investigate the clinicopathologic features of endometrial carcinoma patients with cervical interstitial invasion. Methods： The clinical data from 213 endometrial carcinoma patients with complete medical records admitted from January 2012 to December 2012 were retrospectively analyzed. The potential risk factors for cervical interstitial invasion were evaluated. Results： Among these 213 patients, 71 （33.33%） had cervical interstitial invasion. Univariate analysis found that the factors including age, body mass index, fasting blood glucose level, serum cholesterol level, postoperative pathology, and uterine myoma were not associated with cervical interstitial invasion （P 〉 0.05）, but the histological grade, depth of myometrial invasion, extent of disease and lymph vascular space invasion were significantly associated with cervical interstitial invasion （P 〈 0.05）. The histological grade and the extent of disease were independent risk factors （P 〈 0.05）. As compared with transvaginal ultrasound, magnetic resonance imaging displayed better performance in sensitivity, specificity and accuracy of diagnosis for cervical interstitial invasion. Conclusion： Histological grade and extent of disease are independent risk factors for cervical interstitial invasion of endometrial carcinoma. Magnetic resonance imaging is more reliable than transvaginal ultrasound in predicting cervical interstitial invasion.