子宫内膜癌术后影响因素分析及预后指数模型构建  

Analysis of Influencing Factors and Establishment of Prognostic Index Model for Endometrial Carcinoma after Operation

作　　者：郑丽娥[1] 吴雅兰 谢庆 陈淑敏 黄玉秀[1] ZHENG Li'e;WU Yalan;XIE Qing;CHEN Shumin;HUANG Yuxiu(Department of Gynaecology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China)

机构地区：[1]福建医科大学附属第一医院妇科,福州350005

出　　处：《福建医科大学学报》2021年第5期447-450,共4页Journal of Fujian Medical University

基　　金：福建省卫生厅创新课题(2018-cx-31);福建省自然科学基金项目(2016J01530)。

摘　　要：目的探讨子宫内膜癌术后生存的相关影响因素,构建术后生存的预后指数(PI)预测模型,为提高子宫内膜癌患者术后生存率提供科学依据。方法收集并分析270例子宫内膜癌患者的临床病理及生存资料;采用Kaplan-Meier法计算生存率,绘制生存曲线;运用单因素和多因素的Cox回归模型分析患者术后死亡的独立危险因素,建立PI预测模型,并用X-tile法寻找PI评分的最佳截断点。结果270例中,随访98个月,生存时间为3~98个月,中位生存时间为44.5个月。多因素分析结果显示,肿瘤家族史(X_(1))、病理类型(X_(2))、子宫外受侵(X_(3))是子宫内膜癌死亡的独立危险因素(P<0.05),PI预测模型为PI=1.981 X_(1)+2.191 X_(2)+2.510 X_(3)。X-tile法选取PI的最佳截断点为1.980。结论对于合并有肿瘤家族史、非内膜样腺癌、子宫外受侵等预后高危因素的子宫内膜癌术后患者,临床上应引起高度重视,制定全面的综合治疗方案,加强随访和监测。Objective To explore prognostic factors for postoperative endometrial carcinoma patients and to establish a prognostic index model,so as to provide a scientific basis for improving the survival of patients with endometrial carcinoma surgery.Methods Collecting and analyzing the clinical pathology and survival data of 270 cases of endometrial carcinoma.The Kaplan-Meier was used to calculate the survival rate of patients and the survival curves were drawn.Independent risk factors of postoperative death were analyzed by Cox regression model with single factor and multiple factors.The best cut-off point of prognostic index score was established and selected by X-tile method.Results During a follow-up of 98 months,the survival time was 3-98 months and the median survival time was 44.5 months.Multivariate analysis showed that family history of cancer(X_(1)),pathological type(X_(2))and extrauterine invasion(X_(3))were independent risk factors for endometrial carcinoma death(P<0.05).The prediction model was PI=1.981 X_(1)+2.191 X_(2)+2.510 X_(3).The best cut-off points of the index of prognosis index by X-tile method was 1.980.Conclusion Patients with endometrial carcinoma who are associated with high risk factors such as familial history of tumor,non-endometrioid adenocarcinoma and extrauterine invasion should be given high priority in clinical practice.Clinically,there is a need to develop a comprehensive treatment and strengthening its follow-up and monitoring.

关 键 词：子宫内膜癌 影响因素 生存分析 预后指数模型 

分 类 号：R73[医药卫生—肿瘤]