257例Ⅰ~Ⅱ期子宫内膜癌复发的危险因素分析

Recurrence-Related Factors of 257 Patients with Stage I-II Endometrial Carcinoma

目的:探讨Ⅰ~Ⅱ期子宫内膜癌复发的原因及相关危险因素。方法:回顾性收集2013年6月至2018年6月期间,中国医科大学附属盛京医院收治并连续随访的257例Ⅰ~Ⅱ期子宫内膜癌患者资料,包括一般资料、临床病理资料、随访患者的复发情况。采用单因素及多因素回归模型分析Ⅰ~Ⅱ期子宫内膜癌复发的相关危险因素。结果:257例Ⅰ~Ⅱ期子宫内膜癌患者中,41例复发,复发率为16.0%。肿瘤直径、淋巴脉管浸润、病理分级是影响Ⅰ~Ⅱ期子宫内膜癌复发的独立危险因素(P<0.05)。年龄、高血压、体重指数、手术病理分期、盆腔淋巴结切除术及切除数目不是影响Ⅰ~Ⅱ期子宫内膜癌复发的独立危险因素(P>0.05)。结论:在临床工作中,需要对肿瘤直径>2 cm、存在淋巴脉管浸润、病理分级较高(G2/G3)的Ⅰ~Ⅱ期子宫内膜癌患者密切随访复查,给予患者及时、足量、足疗程的辅助治疗以降低复发率。

Objective:To investigate the risk factors of the recurrence of stage I-II endometrial carcinoma.Methods:We retrospectively analyzed the data of 257 patients with stage I-II endometrial carcinoma treated in Shengjing Hospital of China Medical University from June 2013 to June 2018,including general data,clinicopathological data and data of recurrence.The recurrence rate of the patients was followed up.Multivariate logistic regression model was used to analyze the risk factors of the recurrence of stage I-II endometrial carcinoma.Results:The recurrence rate was 16%(41/257).Tumor size,lym-phovascular space invasion and pathological differentiation were independent risk factors for the recurrence of stage I-II endo-metrial carcinoma(P<0.05).Age,hypertension,body weight,stage of operation and pathology,lymphadenectomy and number of pelvic lymph nodes were not independent risk factors for the recurrence of stage I-II endometrial carcinoma(P>0.05).Conclusion:It is suggested to follow up stage I-II endometrial carcinoma patients with tumor larger than 2 cm,lym-phovascular space invasion or grade G2/G3(pathological differentiation)tumors.The patients should be given timely and sufficient adjuvant treatment to reduce the recurrence rate.