年轻女性Ⅰ期子宫内膜腺癌保留卵巢的临床研究

The clinical study of ovary conservation in young women with stage Ⅰ endometrial adenocarcinoma

目的:探讨Ⅰ期子宫内膜腺癌年轻患者卵巢保留与否对患者预后的影响,分析年轻早期子宫内膜腺癌患者保留卵巢的可行性。方法:回顾性分析我院经病理学检验确诊的105例年龄≤40岁的子宫内膜腺癌患者的卵巢转移发生率,同时对所有患者进行6至11年的随访判断患者的生活质量及心血管疾病和骨质疏松的发病情况。结果:卵巢保留组肿瘤转移的发生率为10.0%(3/30),卵巢切除组肿瘤转移发生率为2.7%(2/75),卵巢保留组和卵巢切除组5年无瘤存活率(DFS)分别为76.7%(23/30)、86.7%(65/75),差异无统计学意义;卵巢保留组相对于卵巢切除组其生活质量明显提高,其中卵巢保留组总生活质量评分为(85.82±7.40),卵巢切除组为(56.34±7.45);心血管疾病和骨质疏松的发病率分别为卵巢保留组3.3%(1/30)和0.0%(0/30),卵巢切除组为12.0%(9/75)和4.0%(3/75),均无显著性差异,但卵巢保留组相对于卵巢切除组患心血管疾病和骨质疏松症的风险也大大降低。结论:对于年轻的I期子宫内膜腺癌患者,保留卵巢可极大地提高其生活质量,减少心血管疾病和骨质疏松的发生,这对年轻子宫内膜癌患者具有重要意义。

Objective：To investigate the different influence of ovarian conservation or not with the stage I endometrial adenocarcinoma in younger patients,meanwhile to analysis the feasibility of ovary conservation in the young patients with early endometrial adenocarcinoma.Methods：Retrospective analye the incidence of ovarian metastasis in the 105 patients whose ages are less than or equall to 40 and with endometrial adenocarcinoma diagnosed by pathology to the hospital.And to explore the patient＇s quality of life and the incidence of cardiovascular disease and osteoporosis of all the patients followed up at 6 to 11 years.Results：The metastasis incidence rate in ovarian conservation group and resection group were10.0%（3/30） and 2.7%（2/75） respectively,the disease-free survival （DFS） of five years in ovarian conservation and resection group were 76.7%（23/30） and 86.7%（65/75） respectively,and the differences were not statistically significant.The life quality of the ovarian conservation group was improved obviously compared with resection group,and they were （85.82±7.40） and （56.34±7.45） respectively.The incidence of cardiovascular disease and osteoporosis in the ovarian conservation group were 3.3%（1/30）,0.0%（0/30） and 12.0%（9/75）,4.0%（3/75） in the ovary resection group,they showed no significant differences,but the risk of cardiovascular disease and osteoporosis in the ovarian conservation group reduce greatly compared with the ovary resection group.Conclusion：For young patients with stage I endometrial adenocarcinoma,ovary conservation can greatly improve the quality of life,reduce the occurrence of cardiovascular disease and osteoporosis,and it＇s important for young patients with endometrial carcinoma.