子宫内膜癌伴卵巢转移影响因素分析

Influence factor analysis of ovarian metastasis in endometrial carcinoma

目的分析子宫内膜癌伴卵巢转移的影响因素。方法回顾性分析2010年6月~2016年6月在湖北省襄阳市中心医院首诊并行手术治疗的310例子宫内膜癌患者的临床病理资料。结果 30例(9.7%,30/310)患者发生卵巢转移。单因素分析显示,子宫内膜癌卵巢转移与病理类型、组织学分级、肌层浸润深度、阴道浸润、输卵管转移、淋巴结转移、腹水细胞学、CA125水平相关(P<0.05),与年龄、绝经、宫颈浸润无明显相关性(P>0.05)。多因素分析显示,子宫内膜癌卵巢转移的独立危险因素包括腹水阳性、高水平CA125、淋巴结转移阳性、组织学分级G2~G3、病理类型为非腺癌、输卵管转移阳性(P<0.05)。结论腹水细胞学检查阳性、高水平CA125、淋巴结转移阳性、组织学分级G2~G3、病理类型为非腺癌、输卵管转移阳性是子宫内膜癌卵巢转移的独立危险因素。子宫内膜癌患者保留卵巢存在可能性,但仍需多中心大样本量研究。

Objective To study the influence factor of ovarian metastasis in endometrial carcinoma. Methods 310 cases of patients with endometrial carcinoma who were first diagnosed and operatively treated in Xiangyang Central Hospital from June 2010 to June 2016 were retrospectively analyzed. Results 30 cases （9.7%） had ovarian metastasis in 310 cases of endometrial carcinoma. Single factor analysis showed that pathological type, histological grade, depth of myometrial invasion, vaginal invasion, fallopian tubes metastasis, lymph node metastasis, peritoneal fluid cytology, CA125 were significantly associated with ovarian metastasis （P 〈 0.05）, while age, menopause, cervical invasion were not significantly associated with ovarian metastasis （P 〉 0.05）. Multiple factors analysis showed that, independent risk factors of ovarian metastasis included positive peritoneal fluid cytology, higher CA125 level, positive lymph node metastasis, histological grade G2-G3, non-adenocarcinoma, positive fallopian tubes metastasis （P 〈 0.05）. Conclusion Positive peritoneal fluid cytology, higher CA125 level, positive lymph node metastasis, histological grade G2-G3, non-adenocarcinoma, positive fallopian tubes metastasis are the independent predictive factors of ovarian metastasis in endometrial carcinoma. Ovarian preservation in patients with endometrial carcinoma is feasible, however, muhi-center and larger sample research is necessary.