子宫内膜癌患者保留卵巢功能手术方案的选择  

Surgical option for preserving ovarian function in patients with endometrial carcinoma

作　　者：王玎[1] 林凤琴[1] 

机构地区：[1]三峡大学仁和医院妇科,宜昌443001

出　　处：《中国肿瘤临床与康复》2016年第5期553-555,共3页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：湖北省教育厅重点项目(D20151202)

摘　　要：目的探讨子宫内膜癌患者保留卵巢功能的手术方案。方法选择2012年8月至2015年8月间接受手术治疗的93例子宫内膜癌患者,其中43例接受保留单侧或双侧卵巢功能的手术者纳入观察组,另50例未保留卵巢功能者纳入对照组。对比两组患者术后的近远期生存率,并进行单因素及危险因素的分析。结果两组患者术后1、3、5年的生存率比较差异均无统计学意义(P>0.05)。卵巢转移与肿瘤病理类型、病理分级、病灶大小、浸润深度、腹水细胞学、血清糖类抗原125等因素有关(P<0.05)。结论子宫内膜癌患者可以选择保留卵巢功能的术式,但应对患者进行综合评价,排除危险因素的患者可认为符合手术适应征。Objective To explore surgical option for preserving ovarian function in patients with endometrial carcinoma. Methods From August 2012 to August 2015,93 patients with endometrial carcinoma who received surgical treatment in Renhe Hospital,China Three Gorges University were selected,in which 43 patients with unilateral or bilateral ovarian function were included in the observation group,and the other 50 cases who were not retained ovarian function were included in the control group. The near or far survival rates were compared between the two groups,and the single factor and the risk factors of ovarian metastasis were analyzed. Results There was no significant difference in the survival rate between the two groups after 1-year,3-year and 5-year（ P〈0. 05）. The proportion of patients who had ovarian metastasis was significantly higher than that of patients with ovarian metastasis at pathological type of other,pathological grading was midder or low differentiation,size of lesion size 2cm,depth of invasion into deep muscle layer,ascites cytology was positive and serum carbohydrate antigen 125（ CA125）,all with statistical difference（ P〈0. 05）. According to Logistic regression analysis,the factors above all were the risk factors of affecting ovarian metastasis. Conclusions Patients with endometrial carcinoma can choose to retain the ovarian function in the operation,but it should be a comprehensive evaluation,and the patients with the risk factors can be considered to be fit for operation.

关 键 词：子宫肿瘤 保留卵巢功能 手术方案 

分 类 号：R737.33[医药卫生—肿瘤]