子宫内膜癌患者术中淋巴结切除和预后的影响因素分析  

Influencing factors of intraoperative lymph node resection and prognosis of patients with endometrial cancer

作　　者：杨影 宗玫 孙付霞 YANG Ying;ZONG Mei;SUN Fuxia(Department of Gynaecology and Obstetrics,Zhumadian Hospital of Traditional Chinese Medicine,Zhumadian 463000,He’nan,China)

机构地区：[1]驻马店市中医院妇产科,河南驻马店463000

出　　处：《癌症进展》2021年第21期2238-2241,共4页Oncology Progress

摘　　要：目的分析影响子宫内膜癌患者术中淋巴结切除和预后的因素。方法收集100例接受初次手术治疗且随访资料完整的子宫内膜癌患者的临床资料。观察不同临床特征的子宫内膜癌患者淋巴结切除情况和预后的差异,分析影响子宫内膜癌患者预后和是否进行淋巴结切除的因素。结果有腹主动脉旁淋巴结(PALN)转移、国际妇产科联盟(FIGO)分期为Ⅲ~Ⅳ期和淋巴脉管间隙浸润(LVSI)阳性的子宫内膜癌患者手术过程中淋巴结切除率分别明显高于无PALN转移、FIGO分期为Ⅰ~Ⅱ期、LVSI阴性患者,差异均有统计学意义(P﹤0.01)。肌层浸润深度≥1/2层、有PALN转移、FIGO分期为Ⅲ~Ⅳ期和LVSI阳性子宫内膜癌患者死亡率分别明显高于肌层浸润深度﹤1/2层、无PALN转移、FIGO分期为Ⅰ~Ⅱ期、LVSI阴性患者,差异均有统计学意义(P﹤0.01)。FIGO分期为Ⅲ~Ⅳ期和有PALN转移是子宫内膜癌患者术中进行淋巴结切除和预后的危险因素。结论 FIGO分期及PALN转移会直接影响子宫内膜癌患者术中是否进行淋巴结切除和预后,可作为临床参考的重要指标。Objective To analyze the influencing factors the intraoperative lymph node resection and prognosis of patients with endometrial cancer(EC).Method The clinical data of 100 naive surgery EC patients who had complete followup data was collected.The differences in the prognosis and conditions of lymph node resection of EC patients with different clinical features were observed,and the factors that affect the prognosis and lymph node resection were analyzed.Result The rate of lymph node resection for patients with paraaortic lymph node(PALN)metastasis,III-IV stages of cervical cancer International Federation of Gynecology and Obstetrics(FIGO)staging and positive lymphatic vascu-lar space infiltration(LVSI)were higher than those with no PALN metastasis,I-II stages of cervical cancer FIGO staging and negative LVSI(P<0.01);the mortality of patients with depth of muscular layer invasion≥1/2 layer,PALN metastasis,III-IV stage of FIGO staging and positive LVSI were higher than those with depth of muscular layer invasion<1/2 layer,no PALN metastasis,I-II stage of FIGO staging and negative LVSI(P<0.01).III-IV stage of FIGO staging and PALN metastasis were risk factors influencing the intraoperative lymph node resection and prognosis of EC patients.Conclusion FIGO staging and PALN metastasis can directly affect the postoperative lymph node resection and prognosis,which can be used as an important indicator for clinical reference.

关 键 词：子宫内膜癌 腹主动脉旁淋巴结转移 国际妇产科联盟分期 预后 

分 类 号：R737.33[医药卫生—肿瘤]