探索子宫内膜间质肉瘤的临床预后因素

Exploring the clinical prognostic factors in endometrial stromal sarcoma

目的:回顾性分析子宫内膜间质肉瘤(endometrial stromal sarcoma,ESS)患者的临床转归结果,探讨影响其预后的因素。方法:收集2009年6月至2020年3月重庆医科大学附属第一医院收治的82例ESS患者临床资料,统计患者年龄、体质指数(body mass index,BMI)、绝经状态、肿瘤大小、淋巴结切除、卵巢保留、组织学类型、分期、辅助治疗情况、CD10等,并对所有患者进行随访。采用统计学软件SPSS 25.0进行数据统计分析,Kaplan-Meier法和log-rank检验进行生存分析,通过Cox回归分析影响预后的因素。结果:82例ESS患者纳入研究,随访时间为2~132个月,5年累计总生存率为71.8%。通过单因素分析发现,绝经状态、是否保留卵巢、组织学类型、分期、雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和Ki-67指数与无进展生存期(progression-free survival,PFS)显著相关,绝经状态、肿瘤大小、组织学类型、分期、ER、PR和Ki-67指数与总生存期(overall survival,OS)显著相关。其中,组织学类型和是否保留卵巢是影响PFS的独立预后因素(P=0.010、0.013),组织学类型是影响OS的独立预后因素(P=0.033)。结论:影响ESS预后的因素较多,组织学类型、是否保留卵巢是ESS的独立预后因素。

Objective:To perform a retrospective analysis of the clinical outcome of patients with endometrial stromal sarcoma(ESS)and to identify prognostic factors.Methods:A total of 82 ESS patients were recruited from June 2009 to March 2020 in The First Affili-ated Hospital of Chongqing Medical University.Their clinical data were collected and analyzed,including age,body mass index,meno-pausal status,tumor size,lymph node resection,ovarian preservation,histological type,stage,adjuvant therapy,and CD10.All patients were followed up.Statistical analysis was performed using SPSS 25.0,the Kaplan-Meier method and log-rank test were used for sur-vival analysis,and Cox regression was used to analyze the prognostic factors.Results:A total of 82 patients with ESS were enrolled in this study.The follow-up time was 2-132 months,and the 5-year cumulative overall survival rate was 71.8%.Univariate analysis showed that menopausal status,ovarian preservation,histological type,stage,and indices(ER,PR,and Ki-67)were significantly corre-lated with progression-free survival.While menopause status,tumor size,histological type,stage,and indices(ER,PR,and Ki-67)were significantly correlated with overall survival.Histological type and ovarian preservation were independent prognostic factors for progression-free survival(P=0.010,0.013),while histological type was an independent prognostic factor for overall survival(P=0.033).Conclusion:There are many factors that affect the prognosis of ESS,and histological type and ovarian preservation are inde-pendent prognostic factors for ESS.