临床Ⅰ期子宫内膜癌患者卵巢转移危险因素分析

Analysis on the risk factors of ovarian metastasis in stage Ⅰ endometrial carcinoma

目的研究拟诊为临床Ⅰ期子宫内膜癌患者卵巢转移的高危因素。方法回顾性分析1985年1月-2016年1月天津医科大学总医院收治的661例临床拟诊为临床Ⅰ期子宫内膜癌患者的病理资料,其中34例(5.1%)存在卵巢转移,14例为隐性转移(2.1%)。结果单因素Logistic回归分析显示,输卵管浸润、组织学类型、肌层浸润深度、宫颈浸润、宫旁浸润、盆腔淋巴结转移、子宫浆膜面受累与临床I期子宫内膜癌卵巢转移存在相关性(P<0.05);多因素Logistic回归分析显示,输卵管浸润、组织学类型、宫旁浸润、盆腔淋巴结转移是临床I期子宫内膜癌卵巢转移的独立危险因素(P<0.05)。结论年轻的子宫内膜样腺癌患者,术中探查卵巢形态正常且排除输卵管浸润、盆腔淋巴结转移、宫旁浸润等危险因素可考虑行保留卵巢手术。

Objective To analyze the risk factors of ovarian metastasis in patients suspected of stage Ⅰ endometrial carcinoma.Methods The pathological data of 661 patients suspected of stage Ⅰ endometrial carcinoma in the hospital from January 1985 to January2016 were restrospectively reviewed and analyzed. Among these cases,there were 34 cases with ovarian metastasis（ 5. 1%） and 14 cases with occult metastasis（ 2. 1%）. Results Univariate logistic regression analysis revealed that tubal metastasis,histological types,depth of myometrial invasion,cervical infiltration,parametrial infiltration,pelvic lymph node metastasis,and invasion of uterine serosa were significantly associated with ovarian metastasis（ P 0. 05）. Multivariate logistic regression analysis revealed that tubal metastasis,histological types,parametrial infiltration and pelvic lymph node metastasis were the dependent risk factors of ovarian metastasis of endometrial carcinoma（ P〈0. 05）. Conclusion Excluding the risk factors,such as tubal metastasis,pelvic lymph node metastasis,parametrial infiltration,ovarian conservative surgery can be considered among the young endometrioid adenocarcinoma patients with normal ovarian morphology during operation.