子宫内膜癌盆腔淋巴结的临床病理特征分析  

Correlation between endometrial carcinoma pelvic lymph nodes metastases and clinical pathologic characteristics and its clinical significance

作　　者：胡春霞[1] 金松[1] 凌奕[1] 何超蔓[1] 吴玲[1] 蒋华[2] 纪武[2] 曹俊伟[1] 

机构地区：[1]海南医学院附属医院,海南海口570102 [2]海南省人民医院,海南海口570102

出　　处：《中国热带医学》2007年第6期923-925,共3页China Tropical Medicine

基　　金：海南省教育厅高校科研基金资助项目(HJKJ200747)

摘　　要：目的研究分析子宫内膜癌患者盆腔淋巴结转移的相关因素及盆腔淋巴清扫术对预后的影响。方法对71例各期子宫内膜癌患者的手术治疗、不同临床病理指标及预后进行回顾性分析。结果71例子宫内膜癌患者淋巴结转移与病理分级(P<0.05)、肌层浸润深度(P<0.01)、宫颈累及(P<0.01)、腹腔冲洗液可见癌细胞(P<0.01)、宫旁或附件累及(P<0.01)均相关,与癌灶累及宫腔面积超过50%或有子宫腔下段及峡部受累者(P>0.05)、年龄(P>0.05)、病理类型(P>0.05)均无相关;淋巴结没有转移患者的生存率明显高于已有转移的患者(P<0.01)。多因素分析显示淋巴结转移以及盆腔淋巴清扫术均不是子宫内膜癌独立的预后影响因素。结论病理分化程度低、深肌层浸润、宫颈浸润、宫旁或附件浸润、腹腔冲洗液细胞学检查阳性是子宫内膜癌盆腔淋巴结转移的高危因素,有盆腔淋巴结转移的患者预后较差。Objective To analyze the factors associated with pelvic cavity lymph node metastases in endometrial carcinoma and clinical pathologic characteristics and its clinical significance and prognosis after pelvic lymphadenectemy. Methods Surgical treatment, clinical pathological criterias and prognosis of 71 cases of endometrial carcinoma in different stages were studied retrospectively. Results 1. Among the 71 endometrial carcinoma cases the lymph node metastases were significantly assocaited with the pathological classification （ P 〈 0.05）, infiltration depth of muscular layer （ P 〈 0.01 ）, cervical invasion （ P 〈 0.01 ）, present of carcinoma cells in pelvic washing fluid （ P 〈 0.01 ） and invasion of paraeervical ligments or affiliates （ P 〈 0.01 ）, but not related with the patients＇ age and pathologic type and the invasion lesion to the uterine cavity 〉 50% or cavitary uteri inferior segment and isthmus uteri infdtration . 2. The survival rate was significantly higher in the patients without lymph node metastases than those with lymph node metastases （ P 〈 0.01 ）, multifactor analysis showed that neither lymph node metastases nor pelvic lymphadenectemy was an independent factor that influenced the prognosis. Conclusion Low pathologic classification, deep infiltration of muscular layer, cervix invasion, paracervical ligments or affiliates, positive cell finding in pelvic washing fluid are high risk factors assoicated with pelvic lymph node metastases of endometrial carcinoma. The prognosis of patients with pelvic lymph node metastases is unfavorable.

关 键 词：子宫内膜肿瘤 淋巴结转移 预后 

分 类 号：R737.33[医药卫生—肿瘤]