Ⅰ型子宫内膜癌患者盆腔淋巴结转移的影响因素分析

Influencing factors analysis of pelvic lymph node metastasis in patients with type I endometrial cancer

目的探讨Ⅰ型子宫内膜癌患者盆腔淋巴结转移的影响因素。方法根据术后病理结果的不同将260例Ⅰ型子宫内膜癌患者分为无盆腔淋巴结转移组(n=242)和盆腔淋巴结转移组(n=18)。比较两组患者的年龄、国际妇产科联盟(FIGO)分期、月经情况、肿瘤直径、肌层浸润深度、分化程度、宫颈受累情况、附件转移情况、脉管浸润情况。采用多因素Logistic回归模型分析Ⅰ型子宫内膜癌患者盆腔淋巴结转移的影响因素。结果单因素分析结果显示,年龄、月经情况可能不是Ⅰ型子宫内膜癌患者盆腔淋巴结转移的影响因素(P﹥0.05);FIGO分期、肿瘤直径、肌层浸润深度、分化程度、宫颈受累情况、附件转移情况、脉管浸润情况均可能是Ⅰ型子宫内膜癌患者盆腔淋巴结转移的影响因素(P﹤0.01)。多因素Logistic回归分析结果显示,FIGO分期、肿瘤直径、肌层浸润深度、分化程度、附件转移情况、脉管浸润情况、宫颈受累情况均是Ⅰ型子宫内膜癌患者盆腔淋巴结转移的独立影响因素(P﹤0.05)。结论FIGO分期、肿瘤直径、肌层浸润深度、分化程度、附件转移情况、脉管浸润情况、宫颈受累情况均是Ⅰ型子宫内膜癌患者盆腔淋巴结转移的独立影响因素,临床需考虑上述因素后制订个体化手术治疗方案,才能降低盆腔淋巴结转移的可能性,从而改善患者的预后。

Objective To investigate the influencing factors of pelvic lymph node metastasis in patients with type I endometrial cancer.Method A total of 260 patients with type I endometrial cancer were divided into the non-pelvic lymph node metastasis group(n=242)and the pelvic lymph node metastasis group(n=18)according to the postoperative pathological results.The age,International Federation of Gynecology and Obstetrics(FIGO)stage,menstrual status,tu-mor diameter,depth of myometrial infiltration,degree of differentiation,cervical involvement,adnexal metastasis,and vascular infiltration were compared between the two groups.Multivariate Logistic regression model was used to analyze the influencing factors of pelvic lymph node metastasis in patients with type I endometrial cancer.Result Univariate analysis showed that age and menstrual status might not be the influencing factors of pelvic lymph node metastasis in pa-tients with type I endometrial cancer(P>0.05);FIGO stage,tumor diameter,depth of myometrial infiltration,degree of differentiation,cervical involvement,adnexal metastasis,and vascular infiltration might be the influencing factors of pel-vic lymph node metastasis in patients with type I endometrial cancer(P<0.01).Multivariate Logistic regression showed that FIGO stage,tumor diameter,depth of myometrial infiltration,degree of differentiation,adnexal metastasis,vascular infiltration,and cervical involvement were independent influencing factors of pelvic lymph node metastasis in patients with type I endometrial cancer(P<0.05).Conclusion FIGO stage,tumor diameter,depth of myometrial infiltration,de-gree of differentiation,adnexal metastasis,vascular infiltration,and cervical involvement are independent factors influenc-ing pelvic lymph node metastasis in patients with type I endometrial cancer,and the individualized surgical treatment should be formulated in clinical practice by considering the above factors in order to reduce the possibility of pelvic lymph node metastasis and improve the prognosis of patients.