子宫内膜癌淋巴结转移的危险因素及预后

Risk factors and prognosis of lymph node metastasis in Endometrial cancer

目的:分析子宫内膜癌淋巴结转移患者的危险因素及预后。方法:收集2015年9月~2019年9月在桂林医学院附属医院接受全面分期手术的198例子宫内膜癌患者的临床病理资料,探讨淋巴结转移的危险因素及与预后的关系。结果:淋巴结转移率8.6%(17/198),非子宫内膜样癌、低分化、FIGO分期晚、深肌层浸润、淋巴血管间隙浸润、MELF浸润和宫颈间质浸润是子宫内膜癌患者淋巴结转移的危险因素(P<0.05)。Logistic回归分析显示,低分化、淋巴血管间隙浸润、深肌层浸润是淋巴结转移的独立危险因素(P<0.05)。患者5年总生存率为94.9%,无淋巴结转移者生存率明显高于有淋巴结转移者,差异有统计学意义(P<0.05)。结论:子宫内膜癌总体预后良好,存在低分化、淋巴血管间隙浸润、深肌层浸润这些危险因素时应行系统盆腔和腹主动脉旁淋巴结切除。

Objective To analyze the risk factors of lymph node metastasis in endometrial cancer and its effect on prognosis.Method The clinicopathdogical data of 198 patients with endometral cancer who underwent comprehesive staged surgery in the Affiliated Hospital of Guilin Medical college from september 2015 to september 2019 were collected to explore the risk factors of lymph node metastasis and its relationship with prognosis.Results The lymph node metastasis rate was 8.6%(17/198).non-endometrioid adenocarcinoma,histological grade G3,the late FIGO stage,deep muscle infiltration,lymph-vascular space involvement,MELF pattern invasion and cervical infiltration were correlation with endometrial cancer(P<0.05).Logistic regression analysis showed that histological grade G3,lymph-vascular space involvement and deep muscle infiltration were independent risk factors for lymph node metastasis in patients with endometrial cancer(P<0.05).The 5-year overall survival rates were 94.9%,Patients without lymph node metastasis had better survival than those with metastasis(P<0.05).Conclusion The overall survival rate of endometrial cancer was satisfactory.It is necessary for patients with high risks of lymph node metastasis to accept systematic pelvic and para-aortic lymphphadenectomy.