早期子宫内膜癌及癌前病变患者保留生育功能治疗后复发的影响因素

Influence factors of recurrence after fertility preservation therapy in patients with early endometrial carcinoma and precancerous lesions

目的探讨早期子宫内膜癌及癌前病变患者保留生育功能治疗后复发的影响因素。方法选取23例ⅠA期子宫内膜高分化腺癌患者及33例子宫内膜不典型增生患者,所有患者经孕激素联合宫腔镜治疗已达到完全缓解,收集并统计所有患者的临床资料。采用Logistic回归分析进行多因素分析,总结出影响孕激素联合宫腔镜治疗后复发的相关因素。结果56例患者经孕激素联合宫腔镜治疗均已达到完全缓解,其中15例出现治疗后复发,41例未出现复发。单因素分析结果提示,不同体重指数(BMI)及是否使用促排卵药患者复发情况比较,差异均有统计学意义(P﹤0.05)。多因素分析结果提示,BMI≥24 kg/m^(2)(OR=14.028,95%CI:1.622~121.325)、使用促排卵药(OR=34.234,95%CI:2.525~464.138)是早期子宫内膜癌及癌前病变患者保留生育功能治疗后复发的危险因素(P﹤0.05)。结论早期子宫内膜癌及癌前病变患者保留生育功能治疗后复发的独立危险因素为BMI≥24 kg/m^(2)、使用促排卵药。

Objective To investigate the recurrence influence factors of early endometrial carcinoma and precancerous lesions after fertility preservation therapy.Method A total of 23 cases of stage IA well-differentiated endometrial adenocarcinoma and 33 cases of endometrial dysplasia were selected.All patients received progesterone+hysteroscopy and achieved complete response.Clinical data of all patients were collected and analyzed.Multivariate analysis was conducted by Logistic regression analysis and the recurrence influence factors of progesterone+hysteroscopy were summarized.Result All 56 cases achieved complete response after progesterone+hysteroscopy with 15 cases of recurrence and 41 cases of non-recurrence.Univariate analysis showed that there were statistically significant differences between recurrent and non-recurrent patients with body mass index(BMI)and ovulation induction drug use(P<0.05).Multivariate analysis showed that BMI≥24 kg/m^(2)(OR=14.028,95%CI:1.622-121.325)and ovulation induction drugs(OR=34.234,95%CI:2.525-464.138)were risk factors for recurrence of early endometrial carcinoma and precancerous lesions after fertility preservation therapy(P<0.05).Conclusion BMI≥24 kg/m^(2) and ovulation induction drugs are independent risk factors for recurrence of early endometrial carcinoma and precancerous lesions after fertility preservation therapy.