子宫内膜样腺癌肿瘤细胞转移高危因素分析

Analysis of the high risk factors of tumor cell metastasis of the patients with endometrioid adenocarcinoma

目的:探究子宫内膜样腺癌肿瘤细胞转移的高危因素。方法:选取2017年8月-2020年10月安徽医科大学附属阜阳医院和附属第一医院妇产科收治的108例子宫内膜样腺癌患者,根据患者是否发生肿瘤细胞宫体外转移分为肿瘤细胞转移19例和未转移89例。收集并统计患者年龄、绝经状况、组织学分级、雌激素受体、肌层浸润深度、肿瘤大小、肿瘤蛋白p53、癌抗原125及外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)水平等临床资料。分析子宫内膜样腺癌肿瘤细胞转移与临床特征关系;采用多因素logistic回归分析影响子宫内膜样腺癌肿瘤细胞转移的高危因素。结果:子宫内膜样腺癌肿瘤细胞转移与否其患者年龄、绝经状况、肿瘤大小、癌抗原125无差异(P>0.05),而在患者组织学分级、雌激素受体、肌层浸润深度、肿瘤蛋白p53、外周血NLR、PLR存在差异(P<0.05)。多因素logistic回归分析显示,雌激素受体、外周血NLR、PLR是子宫内膜样腺癌肿瘤细胞发生转移的独立危险因素(P<0.05)。结论:子宫内膜样腺癌肿瘤细胞转移的独立危险因素为雌激素受体、NLR、PLR。

Objective: To explore the high risk factors of tumor cell metastasis of the patients with endometrioid adenocarcinoma(EA). Methods: From August 2017 to October 2020, 108 patients with EA were selected as research objects, and they were divided into 19 patients with tumor cell metastasis and 89 patients without tumor cell metastasis according to whether the patients had tumor cell metastasis in vitro. The age, menopause status, histological grade, estrogen receptor, myometrial invasion depth, tumor size, the levels of tumor protein p53 and cancer antigen 125, the values of peripheral blood neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio(PLR), and other clinical data were collected and statistically analyzed. The relationship between tumor cell metastasis and clinical features of EA was analyzed. Multivariate Logistic regression was used to analyze the high risk factors of cell migration of EA. Results: There were no significant different in the cell migration rate of EA among the patients with different age, with different menopause status, with different tumor size, or with different tumor antigen 125 level(P>0.05). but there were significant different in the cell migration rate of EA among the patients with different histological grade, with different estrogen receptor level, with different myometrial invasion depth, with different tumor protein p53 level, or with different values of peripheral blood NLR and PLR(P<0.05). Multivariate Logistic regression analysis showed that estrogen receptor level, and the values of peripheral blood NLR and PLR were independent risk factors of cell migration of EA(P<0.05). Conclusion: The independent risk factors of tumor cell metastasis of EA are estrogen receptor level, and the values of NLR and PLR.