45岁以下子宫内膜癌患者术后3年生存影响因素分析

Analysis of 3 years survival of patients with endometrial cancer below 45 years of age

目的：分析45岁以下子宫内膜癌患者术后3年生存影响因素。方法：收集2009年1月至2011年12月在唐山市妇幼保健院诊断为子宫内膜癌的患者,均行子宫全切术,术后病理证实为子宫内膜癌患者88例。并根据其年龄将其分为A组（≤35岁）35例,B组（36~45岁）53例,对2组患者的生存影响因素进行单因素及多因素分析。结果：对患者的预后因素中组织学类型、病理分级、肌层浸润深度、淋巴结转移、附件转移、腹腔细胞学、雌孕激素受体等7个因素行单因素分析,结果显示组织学类型、病理分级、肌层浸润深度、淋巴结转移、附件转移、腹腔细胞学对患者的预后有影响（P均〈0.05）。雌激素受体阳性患者3年生存率高于雌激素受体阴性患者,有统计学意义（P〈0.05）。孕激素受体对患者预后无影响（P〉0.05）。45岁以下子宫内膜癌术后放疗、化疗、孕激素治疗三者3年生存比较,无明显差异（P〉0.05）。未接受治疗患者3年生存率为57.14%,低于接受放疗、化疗、孕激素治疗患者的3年生存率,均有统计学意义（P〈0.05）。多因素回归分析得出肿瘤浸润深度、淋巴结转移是影响预后的独立因素。结论：45岁以下子宫内膜癌患者其发生与雌激素有关,尤其是≤35岁者,高危因素少,预后较好。对于早期45岁以下子宫内膜癌患者可考虑保留生育功能或卵巢。早期发现、早期诊断是提高45岁以下子宫内膜癌患者术后3年生存率的核心,早期手术治疗及术后辅助治疗是提高患者术后3年生存率的保障。

Objective：To analye 3 years of survival factors of 45 years old patients with endometrial cancer. Methods ： Endometrial cancer patients 88 cases, underwent hysterectomy, were divided into A group （ ≤ 35 years old） 35 cases,B group（36 -45 years old） 53 cases. The survival of the 2 groups of patients were analyzed by univariate and multivariate analysis. Results ： Histological type, pathological grade, myometrial invasion depth, lymph node metastasis, adnexa metastasis, peritoneal cytology, were related with the patient＇s prognosis ,P 〈 0.05. Estrogen receptor positive patients 3 years survival rate was higher than estrogen receptor negative patients （ P 〈 0.05 ）. The 3 years survival rate of patients without treatment was only 57.14%, compared with the of patients receiving radiotherapy, chemotherapy, and progesterone, respectively,which had statistical significance （ P 〈 0.05 ）. Multiple regression analysis showed that the depth of tumor invasion and lymph node metastasis were independent prognostic factors. Conclusion： Endometrial carcinoma in patients below 45 years of age were associated with estrogen, especially less than or equal to 35 years old, prognosis was better. For patients with endometrial carcinoma under the age of 45 years, the retention of fertility or ovarian cancer may be considered. Early diagnosis and early surgical treatment and postoperative adjuvant therapy are important.