子宫内膜癌淋巴结转移发生情况及其高危因素的Meta分析

Incidence and high risk factors of lymph node metastasis in endometrial cancer:a Meta-analysis

目的系统评价子宫内膜癌淋巴结转移发生情况及其高危因素。方法计算机检索Web of Science、PubMed、Cochrane Library、知网、维普等数据库,根据筛选标准纳入有关子宫内膜癌淋巴结转移高危因素的历史性队列研究。对纳入文献进行质量评价后,采用RevMan5.3软件进行Meta分析。结果共纳入8篇文献。Meta分析结果显示,子宫内膜癌淋巴结转移的发生率为11%;根据国际妇产科联盟分期,早期子宫内膜癌的淋巴结转移率仅为0~0.99%,而中晚期高达8%。对于所有分期子宫内膜癌,高病理组织学分级、宫颈间质浸润、肌层浸润大于50%、附件区转移、肿瘤大于2 cm、淋巴血管间隙浸润均为淋巴结转移发生的危险因素(均P<0.05)。结论中晚期子宫内膜癌淋巴结转移率较早期子宫内膜癌高。病理组织学分级高、宫颈间质浸润、肌层浸润大于50%、附件区转移、肿瘤大于2 cm、淋巴血管间隙浸润的子宫内膜癌患者更易发生淋巴结转移。

Objective To systematically review the incidence and high risk factors of lymph node metastasis in endometrial cancer.Methods A computer-based retrieval was performed in the databases including Web of Science,PubMed,Cochrane Library,CNKI and VIP,and historical cohort studies about high risk factors of lymph node metastasis in endometrial canceRwere included in accordance with screening standards.AfteRquality assessment of the literatures enrolled,a Meta-analysis was conducted by using RevMan 5.3 software.Results Eight literatures were enrolled ultimately.The results of Meta-analysis revealed that the incidence rate of lymph node metastasis was 11%in endometrial cancer;and the rate of lymph node metastasis was only 0-0.99%in endometrial canceRwith the early stage of International Federation of Gynecology and Obstetrics and up to 8%in the middle-late stage.FoRendometrial canceRin all stages,higheRhistopathology grade,cervical myometrial invasion,myometrial invasion depth>50%,accessory metastasis,tumoRdiameter>2cm,and lymph-vasculaRspace invasion were the risk factors foR developing lymph node metastasis(all P<0.05).Conclusion The rate of lymph node metastasis in endometrial canceRwith middle-late stage is higheRthan that in early stage.The endometrial canceRpatients with higheR histopathology grade,cervical myometrial invasion,myometrial invasion depth>50%,accessory metastasis,tumoRdiameter>2cm,and lymph-vasculaRspace invasion are more liable to suffeRfrom lymph node metastasis.