子宫内膜癌淋巴结转移及临床病理因素与预后的相关性  

Correlations among lymph node metastasis,clinical pathological features and prognosis of endometrial carcinoma

作　　者：佐晶[1] 安菊生[1] 宋艳[2] 李卓[2] 张蓉[1] 李斌[1] 吴令英[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院肿瘤研究所妇瘤科,北京100021 [2]中国医学科学院北京协和医学院肿瘤医院肿瘤研究所病理科,北京100021

出　　处：《基础医学与临床》2016年第6期840-845,共6页Basic and Clinical Medicine

摘　　要：目的研究子宫内膜癌的淋巴结转移等临床病理因素与预后的关系。方法回顾性分析105例术后病理证实存在淋巴结转移的子宫内膜样腺癌患者的临床病理资料,分析盆腔淋巴结(髂总、髂内、髂外、闭孔淋巴结)转移、腹主动脉旁淋巴结转移、肿瘤位置、分化程度、肌层受侵、淋巴血管间隙浸润(LVSI)、雌孕激素受体表达等因素对总生存期(OS)和无病生存期(DFS)的影响。结果存在子宫外受侵的患者更易发生腹主动脉旁淋巴结转移(P<0.01);肌层受侵、子宫外受侵、腹腔冲洗液细胞学检查阳性与患者的OS、DFS缩短密切相关(P<0.05)。结论肿瘤侵犯至子宫外的患者更易发生腹主动脉旁淋巴结转移;肌层受侵、子宫外受侵、腹腔冲洗液细胞学检查阳性是子宫内膜癌的独立预后不良因素。Objective To investigate the relationship among lymph node metastasis,clinical pathological features and prognosis of endometrial carcinoma. Methods One hundred and five patients were enrolled in this retrospective study. They were pathologically diagnosed as endometrioid endometrial cancer（ EEC） with pelvic and / or paraaortic lymph node metastasis. Clinical and pathological data showed pelvic lymph nodes（ iliac,internal iliac,external iliac,obturator lymph nodes） and para-aortic lymph node metastasis,tumor location,tumor differentiation,myometrial invasion,lymph vascular space invasion,estrogen and progesterone receptor expressions have important impacts on OS（ overall survival） and DFS（ disease free survival）. Results Patients with invasion beyond the uterus were more likely to have para-aortic lymph node metastasis（ P 〈0. 01）. Myometrial invasion,external invasion of uterus and peritoneal cytology positive were related to shortened OS and DFS（ P〈0. 05）. Conclusions The patients with tumor invasion beyond the uterus are more likely to have paraaortic lymph node metastasis. myometrium involvement,external invasion of uterus and peritoneal cytology positive are the indepedent negative prognosis factors in endometrial cancer.

关 键 词：子宫内膜癌 淋巴结转移 预后 

分 类 号：R737.33[医药卫生—肿瘤]