Ⅱ型子宫内膜癌行网膜切除手术必要性的探讨

The necessity of omentectomy for typeⅡendometrial cancer surgery

目的探讨是否应将网膜切除纳入Ⅱ型子宫内膜癌患者的常规手术中。方法回顾性分析2006年1月至2019年12月北京大学第三医院妇科术后病理诊断为Ⅱ型子宫内膜癌患者的临床病理资料,分析不同病理亚型患者网膜转移情况及与患者病理类型、深肌层浸润、附件受累及淋巴结阳性的关系。结果115例行网膜切除或活检的Ⅱ型子宫内膜癌患者中,有网膜转移者17例(14.8%),其中4例为镜下转移。网膜转移发生率最高者为癌肉瘤(21.4%,3/14)。附件受累和淋巴结阳性与网膜转移有关(P=0.000,0.039)。结论网膜转移在Ⅱ型子宫内膜癌中并不少见,网膜切除应作为Ⅱ型子宫内膜癌手术的一部分。

Objective To investigate whether omentectomy should be a part of a procedure in patients with typeⅡendometrial cancer(EC).Methods Patients diagnosed with typeⅡEC in Peking University Third Hospital between 2006 and 2019 were retrospectively reviewed.Data of patients,including histological types,depth myometrial invasion,adnexal involvement,lymphovascular invasion,and omental metastasis were recorded.Risk factors of omental metastasis were analyzed.Results 115 patients with typeⅡEC have received omentectomy or omentum biopsy.14.8%(17/115)were diagnosed as omental metastases,4 cases were microscopic omental metastases.The highest rate of omental metastasis was found in carcinosarcoma(21.4%,3/14).Adnexal metastasis and lymphovascular invasion were the factors associated with omental metastasis(P=0.000,0.039,respectively).Conclusion Omental metastasis is not uncommon in typeⅡEC.Omentectomy should be a part of the procedures in patients with typeⅡEC.