宫腔镜电切术联合地屈孕酮治疗子宫内膜癌的疗效及术后复发的相关影响因素分析

Effect of Hysteroscopic Electrotomy Combined with Dydrogesterone in the Treatment of Endometrial Cancer and Related Factors of Postoperative Recurrence

目的探究宫腔镜电切术联合地屈孕酮治疗子宫内膜癌的疗效及术后复发的相关影响因素。方法将60例子宫内膜癌患者按随机数字表法分为对照组(n=30)和观察组(n=30)。对照组给予宫腔镜电切术治疗,观察组在此基础上联合地屈孕酮治疗,2组均连续治疗3个月。统计2组治疗后临床疗效。对术后疗效为缓解的45例子宫内膜癌患者进行为期4年的随访,对预后相关因素采取单因素和多因素Logistic回归分析。结果观察组术后缓解率显著高于对照组(P<0.05)。多因素Logistic回归分析显示,有淋巴结转移、腹腔细胞学检查阳性、病理分级为G3、肌层浸润深度≥1/2以及术后未联合使用地屈孕酮为子宫内膜癌患者术后复发的独立危险因素(OR=3.421、2.343、4.305、3.124、2.817,P<0.05)。结论宫腔镜电切术联合地屈孕酮可有效提高子宫内膜癌患者术后缓解率。淋巴结转移、腹腔细胞学检查阳性、病理分级为G3、肌层浸润深度≥1/2以及术后未联合使用地屈孕酮为子宫内膜癌患者术后复发的独立危险因素。

Objective To explore the effect of hysteroscopic electrotomy combined with dydrogesterone in the treatment of endometrial cancer and the related factors of postoperative recurrence.Methods 60 cases of endometrial cancer were divided into the control group(n=30)and the observation group(n=30).The control group was treated with hysteroscopic electrotomy.The observation group was treated with dydrogesterone on this basis.Both groups were treated continuously for 3 months.The clinical efficacy of the two groups after treatment was counted.45 cases of endometrial cancer with remission after operation were followed up continuously for 4 years,and the related prognostic factors were analyzed by single factor and multivariate logistic regression analysis.Results The remission rate in the observation group was significantly higher than that of the control group(P<0.05).Multivariate logistic regression analysis showed that lymph node metastasis,positive abdominal cytology,pathological grade of G3,depth of myometrial invasion≥1/2 and no combined use of dydrogesterone after operation were independent risk factors for recurrence of endometrial cancer patients(OR=3.421、2.343、4.305、3.124、2.817,P<0.05).Conclusion Hysteroscopic electrotomy combined with dydrogesterone can effectively improve the remission rate of endometrial cancer patients.Lymph node metastasis,positive abdominal cytology,pathological grade of G3,depth of myometrial invasion≥1/2 and no combined use of dydrogesterone after operation are independent risk factors for recurrence of endometrial cancer patients.