早期子宫内膜癌患者腹水细胞学检查阳性的危险因素及其对早期子宫内膜癌预后的影响研究  

Study on the risk factors of positive peritoneal cytology examination results and its impact on the clinical prognosis of patients with early endometrial cancer

作　　者：刘晓敏 苏俊玲 杜洁 张龙 毛建英 LIU Xiaomin;SU Junling;DU Jie;ZHANG Long;MAO Jianying(Department of Obstetrics and Gynecology,People's Hospital of Inner Mongolia Autonomous Region,Huhhot 010017,Neimenggu,China;Department of Medical Sciences,Inner Mongolia Medical University,Huhhot 010010,Neimenggu,China)

机构地区：[1]内蒙古自治区人民医院妇产科,呼和浩特010017 [2]内蒙古医科大学医科科学部,呼和浩特010010

出　　处：《中国性科学》2019年第9期46-50,共5页Chinese Journal of Human Sexuality

基　　金：2017年内蒙古自然科学基金面上项目(2017MS08110)

摘　　要：目的探讨早期子宫内膜癌患者腹水细胞学检查阳性的危险因素及其对早期子宫内膜癌预后的影响。方法选取2016年1月至2017年10月内蒙古自治区人民医院诊治的186例子宫内膜癌患者作为研究对象。对186例早期子宫内膜癌患者进行腹水细胞学检查,观察检查阳性者与阴性者的临床资料,采用Logistic回归方程进行计算,分析影响早期子宫内膜癌患者腹水细胞学检查阳性的危险因素,并探讨其对早期子宫内膜癌预后的影响。结果 186例早期子宫内膜癌患者中,45例腹水细胞学检查呈阳性,其余均为阴性,腹水细胞学阳性危险因素的单因素包括年龄、肿瘤直径、肌层浸润深度、宫颈浸润深度、宫颈间质侵犯、淋巴血管间隙受累等,均具有统计学意义(均P<0.05)。将上述有差异单因素带入Logistic回归方程计算,发现腹水细胞学阳性危险因素的多因素包括年龄、肿瘤直径、肌层浸润深度、宫颈浸润深度、宫颈间质侵犯、淋巴血管间隙受累等。随访调查发现,腹水细胞学检查阳性者的复发率及远处复发率明显高于阴性者,差异具有统计学意义(P<0.05),腹腔细胞学阳性病患的2年累积生存率为60.68%,而阴性患者的生存率高达74.69%,差异具有统计学意义(P<0.05)。结论早期子宫内膜癌患者腹水细胞学检查阳性的危险因素较多,并且其对患者的复发及预后有一定影响,建议临床腹水阳性的相关因素及时采取相应对策,积极防治。Objective To study the risk factors of positive peritoneal cytology examination results and its impact on the clinical prognosis of patients with early endometrial cancer. Methods 186 endometrial cancer patients underwent the peritoneal cytology examination from January 2016 to October 2017 in our hospital were selected. The clinical data among positive and negative patients was collected. The Logistic regression equation was used to analyze the risk factors of positive examination results and its impact on patients′ prognosis. Results Based on the peritoneal cytology examination, there were 45 positive cases and 141 negative cases. The single factors of the positive peritoneal cytology examination results included age, tumor diameter, myometrial invasion depth, metastasis of omentummajus, cervical invasion depth, cervical mesenchyme invasion and lymph-vascular space invasion, all with statistically significant differences(all P<0.05). According to the Logistic regression equation, all the factors above were also the multi-factors of positive examination results. The recurrence rate and distant recurrence rate in positive patients was significantly higher than that in negative patients, with statistically significant differences(P<0.05). The 2-year accumulate survival rate of positive patients and negative patients was 60.68% and 74.69% respectively, with statistically significant differences(P<0.05).Conclusions There aremultiple risk factors of positive examination results, which affects patient′s recurrence rate and clinical prognosis. Therefore, proper andtargeted control measures should be taken according to the risk factors.

关 键 词：子宫内膜癌 腹水细胞学检查 阳性 危险因素 预后 

分 类 号：R711[医药卫生—妇产科学]