子宫低级别子宫内膜样癌淋巴脉管间隙浸润的影响因素  

Influence Factors of Lymphovascular Space Invasion in Low-grade Endometrioid Carcinoma of Uterus

作　　者：郝敏[1] 郑晓丹[2] 魏雪静[2] 马楠[1] 蒋沫怡 朱夏琴 李松芳 Hao Min;Zheng Xiaodan;Wei Xuejing(Department of Obstetrics and Gynecology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;不详)

机构地区：[1]首都医科大学附属北京友谊医院妇产科,北京100050 [2]首都医科大学附属北京友谊医院病理科,北京100050

出　　处：《中国微创外科杂志》2024年第8期529-533,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨子宫低级别子宫内膜样癌患者淋巴脉管间隙浸润(lymphovascular space invasion,LVSI)的影响因素。方法回顾性分析2015年1月~2023年5月167例手术病理诊断低级别(G1、G2)子宫内膜样癌患者的临床资料。选择年龄、是否绝经、异常阴道出血时间、合并代谢综合征、CA125升高(≥35 U/ml)、子宫内膜厚度、宫腔占位、合并子宫腺肌症、国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)2009分期9项指标进行单因素分析,对P<0.05的因素进行二元logistic回归分析。结果167例子宫低级别子宫内膜样癌患者中,LVSI 24例(14.4%)。对单因素分析中P<0.05的4项因素(异常阴道出血时间≥4个月、CA125升高、合并子宫腺肌症、分期Ⅱ期及以上)进行二元logistic回归分析,结果显示分期Ⅱ期及以上(OR=7.357,95%CI:2.140~25.288,P=0.002),CA125升高(OR=4.883,95%CI:1.612~14.794,P=0.005)为子宫低级别子宫内膜样癌LVSI的独立预后因素。结论FIGO 2009分期Ⅱ期及以上、CA125≥35 U/ml与子宫低级别子宫内膜样癌患者LVSI有关,间接提示淋巴结转移风险,术前应高度关注,以便制定更为精准的手术方案。Objective To investigate the influence factors of lymphovascular space invasion(LVSI)in patients with low-grade endometrioid carcinoma.Methods Clinical data of 167 patients with low-grade(G1,G2)endometrioid carcinoma of uterus diagnosed by surgical pathology from January 2015 to May 2023 were retrospectively analyzed.Univariate analysis of the following 9 indicators was performed:age,postmenopausal status,abnormal vaginal bleeding duration,combined with metabolic syndrome,increased CA125(≥35 U/ml),endometrial thickness,uterine occupation,combined with adenomyosis of uterus,stage of the International Federation of Gynecology and Obstetrics(FIGO)2009 standards.The binary logistic refression analysis was made on factors with P<0.05.Results Among the 167 patients with low-grade endometrioid carcinoma of uterus,24 cases(14.4%)had LVSI.The binary logistic regression analysis was performed for 4 factors(abnormal vaginal bleeding duration≥4 months,increased CA125,combined with adenomyosis of uterus,stageⅡand above)with P<0.05 in the univariate analysis,and the results showed stageⅡand above(OR=7.357,95%CI:2.140-25.288,P=0.002)and increased CA125(OR=4.883,95%CI:1.612-14.794,P=0.005)were an independent prognostic factor for LVSI in low-grade endometrial carcinoma of uterus.Conclusion StageⅡ(FIGO 2009)and above and CA125≥35 U/ml are associated with LVSI in patients with low-grade endometrioid carcinoma,indirectly suggesting the risk of lymph node metastasis,which should be paid close attention to before surgery in order to develop a more accurate surgical plan.

关 键 词：子宫内膜癌 低级别 子宫内膜样癌 淋巴脉管间隙浸润 

分 类 号：R737.33[医药卫生—肿瘤]