子宫内膜癌经腹膜后淋巴结切除术后淋巴结转移的危险因素分析

Analysis of the Risk Factors for Lymph Node Metastasis After Retroperitoneal Lymphadenectomy for Endometrial Carcinoma

目的分析子宫内膜癌(EC)经腹膜后淋巴结切除术后淋巴结转移的危险因素。方法选择88例EC患者均行子宫切除及淋巴结清扫术。收集患者一般资料,统计淋巴结转移发生情况,并依据术后淋巴结转移与否将其分为转移组(n=25)、未转移组(n=63)。采用多因素Logistic回归方法对EC经腹膜后淋巴结切除术后淋巴结转移的危险因素进行分析。结果88例EC患者术后出现淋巴结转移25例,淋巴结转移率为28.41%(25/88);转移组病理分期Ⅲ+Ⅳ期、病理类型浆液性乳头状癌+透明细胞癌、组织学分级G3、病灶直径≥2 cm、深肌层浸润、脉管浸润患者占比高于未转移组,有统计学差异;两组在年龄、腹腔积液细胞学、附件转移、宫颈浸润方面对比,无统计学差异;Logistic回归分析显示,病理分期、病理类型、组织学分级、病灶直径、肌层浸润、脉管浸润为影响EC经腹膜后淋巴结切除术后淋巴结转移的独立危险因素(P<0.05且OR≥1)。结论影响EC经腹膜后淋巴结切除术后淋巴结转移的独立危险因素主要为病理分期、病理类型、组织学分级、病灶直径、肌层浸润、脉管浸润,临床应高度重视,以早期发现、早治疗。

Objective To analyze the risk factors for lymph node metastasis after retroperitoneal lymphadenectomy of endometrial carcinoma(EC).Methods 88 EC patients were treated with hysterectomy and lymph node dissection.General patient data were collected to calculate the occurrence of lymph node metastasis and were classified into metastasis(n=25)or not(n=63).Risk factors for lymph node metastasis after EC retroperitoneal lymphadenectomy were analyzed by multivariate Logistic regression.Results 88 EC patients developed lymph node metastasis,The rate of lymph node transfer was 28.41%(25/88);The proportion of patients with stage+,+transparent cell carcinoma of serous papillary carcinoma,histological grade G3,lesion diameter≥2 cm,deep mylayer infiltration,and infiltration of pulse vessels was higher than in the unmetastatic group,There were statistical differences;The 2 groups were compared in age,peritoneal effusion cytology,appendage metastasis,and cervical infiltration,No statistical difference was observed;The Logistic regression analysis showed that,pathological stage,pathological type,histological grade,lesion diameter,myosphere infiltration,and vascular infiltration were independent risk factors affecting lymph node metastasis after EC retroperitoneal lymphadenectomy(P<0.05 and OR≥1).Conclusion The independent risk factors affecting lymph node metastasis after EC are mainly pathological stage,pathological type,histological grade,lesion diameter,myosphere infiltration,which should be paid great attention to for early detection and early treatment.