子宫内膜癌细胞学检查阳性与淋巴转移的关系研究

Clinical study on relationship between positive peritoneal lavage cytology and lymph node metastasis in endometrial carcinoma

目的研究早期子宫内膜癌患者腹腔冲洗液细胞学检查阳性(PPC)与淋巴结转移的关系。方法分析2010~2015年山东省高密市中医院接受手术病理分期的294例子宫内膜癌患者的临床和病理资料,其中10例患者(3.4%)腹腔冲洗液细胞学检查呈阳性(PPC组),284例患者呈阴性(NPC组)。结果两组病理类型和肿瘤分级比较有差异(P<0.05)。调整多变量模型中其他影响因素,腹腔冲洗液细胞学阳性仍然是淋巴结转移的独立危险因素(P<0.05)。结论子宫内膜癌患者腹腔冲洗液细胞学检查阳性提示患者出现淋巴结转移的风险增高且预后不良。虽然腹腔冲洗液的细胞学检查不再是子宫内膜癌国际妇产科联盟分期标准之一,但是在临床决策过程中仍然具有重要作用。

Objective To study the correlation between positive peritoneal lavage cytology and lymph node metastasis in early endometrial cancer.Methods The clinical and pathological data of endometrial cancer patients who accepted surgical pathological staging in our hospital from 2010 to 2015 were retrospectively analyzed.Among them,10 patients(3.4%)had positive peritoneal lavage cytology(PPC group)and 284 had negative peritoneal lavage cytology(NPC group).For statistical analysis,Chi-square test and logistic regression model were used.Results Lymph node metastasis rate in the PPC group was significantly higher than that in the NPC group,regardless of histopathological types(P<0.05).Adjusting other influencing factors in the multivariable model,positive peritoneal cytology was still an independent risk factor for lymph node metastasis(P<0.05).Conclusions Endometrial cancer patients with positive peritoneal cytology are at high risk of lymph node metastasis and poor prognosis.Although peritoneal fluid cytology is no longer one of the FIGO endometrial cancer staging criteria,it still plays an important role in the process of clinical decision-making.