子宫内膜癌患者开腹术后预后不良的危险因素分析  

Analysis of Risk Factors for Poor Prognosis in Patients with Endometrial Cancer after Open Surgery

作　　者：张东霞 ZHANG Dongxia(Jiamusi Central Hospital,Heilongjiang Province,Jiamusi 154002,China)

机构地区：[1]黑龙江省佳木斯市中心医院,黑龙江佳木斯154002

出　　处：《中国医学创新》2022年第25期14-18,共5页Medical Innovation of China

基　　金：黑龙江省卫生健康委科研课题(2019343)。

摘　　要：目的:分析子宫内膜癌患者开腹术后预后不良的危险因素。方法:选择2018年7月-2019年7月于佳木斯市中心医院住院并接受开腹手术治疗的子宫内膜癌患者70例为研究对象。搜集整理患者的病历资料,统计患者手术至随访截止时预后情况,并根据预后将患者分为预后良好组及预后不良组,比较两组临床病理指标,以及术前外周血单核细胞(M)、淋巴细胞(L)、中性粒细胞(N)、血小板计数(PLT)、中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、血小板与淋巴细胞比值(PLR);统计比较患者贫血情况。多因素logistic回归分析判断上述指标对子宫内膜癌患者术后预后的影响。结果:截至2021年12月,70例患者中预后不良患者20例(28.57%),预后良好患者50例(71.43%)。预后不良组年龄≥55岁、FIGO分期>Ⅱ期、病理类型为非子宫内膜样腺癌、有淋巴结转移比例均高于预后良好组(P<0.05)。预后不良组M、N、NLR、MLR及贫血率均高于预后良好组,而L低于预后良好组,差异均有统计学意义(P<0.05);两组PLT、PLR比较,差异均无统计学意义(P>0.05)。logistic回归分析显示,年龄≥55岁、非子宫内膜样腺癌、FIGO分期>Ⅱ期、淋巴结转移、贫血及高M、NLR、MLR均为患者不良预后的危险因素,而高L为保护因素(P<0.05)。结论:除常见临床病理指标外,术前外周血低L及高M、NLR、MLR、贫血均不利于开腹治疗的子宫内膜癌患者预后,应加强对此类人群术前治疗及术后监测。Objective:To analyze the risk factors of poor prognosis in patients with endometrial cancer after open surgery.Method:A total of 70 patients with endometrial cancer underwent open surgery in Jiamusi Central Hospital from July 2018 to July 2019 were selected as the research objects.The medical records of patients were collected and sorted out,the prognosis of patients from operation to the end of follow-up were counted.Patients were divided into good prognosis group and poor prognosis group according to the prognosis.The clinical pathological indexes and peripheral blood monocytes(M),lymphocytes(L),neutrophils(N),platelet count(PLT),neutrophils to lymphocytes ratio(NLR),monocytes to lymphocytes ratio(MLR),platelet to lymphocytes ratio(PLR)were compared between the two groups.The anemia status of patients was statistically compared.Multivariate logistic regression analysis was used to determine the influence of the above indexes on the postoperative prognosis of patients with endometrial cancer.Result:Until December 2021,among the 70 patients,20 patients(28.57%)were with poor prognosis and 50 patients(71.43%)were with good prognosis.In the poor prognosis group,the proportions of age≥55 years,FIGO stage>stageⅡ,pathological type of non-endometrioid adenocarcinoma and lymph node metastasis were higher than those in the good prognosis group(P<0.05).The M,N,NLR,MLR and anemia rates in poor prognosis group were higher than those in good prognosis group,while L was lower than that in good prognosis group,the differences were all statistically significant(P<0.05).There were no significant differences in PLT and PLR between the two groups(P>0.05).Multivariate logistic regression analysis showed that age≥55 years old,non-endometrioid adenocarcinoma,FIGO stage>stageⅡ,lymph node metastasis,anemia and high M,NLR,MLR were risk factors for poor prognosis,while high L was protective factor(P<0.05).Conclusion:In addition to common clinical and pathological indicators,low L and high M,NLR,MLR in preoperative peripheral blood

关 键 词：子宫内膜癌 外周血指标 贫血 预后 

分 类 号：R737.33[医药卫生—肿瘤]