高体质量指数和使用促排卵药的交互作用与子宫内膜癌保留生育功能治疗后复发风险的关联分析  

Interaction of high body mass index and use of ovulation stimulating drugs with risk of relapse after fertility preservation therapy of endometrial cancer

作　　者：李娜[1] 苗卉[1] 付亚静 苗聪秀[1] LI Na;MIAO Hui;FU Yajing;MIAO Congxiu(Department of Reproductive Genetics,Heping Hospital of Changzhi Medical College,Changzhi 046000,China)

机构地区：[1]长治医学院附属和平医院生殖遗传科,山西长治046000

出　　处：《肿瘤基础与临床》2024年第4期393-397,共5页journal of basic and clinical oncology

基　　金：山西省卫生健康委生殖工程重点实验室项目(2021SYS21);山西省卫生健康委科研项目(2022134);山西省卫生健康委“四个一批”科技兴医创新计划项目(2021XM38)。

摘　　要：目的探讨高体质量指数和使用促排卵药的交互作用与子宫内膜癌(EC)保留生育功能治疗后复发风险的关联。方法选取2021年1月至2023年1月于长治医学院附属和平医院接受保留生育功能治疗的58例早期EC患者,所有患者经孕激素联合宫腔镜治疗均已达到完全缓解,收集并统计患者的临床资料。采用单因素、多因素Logistic回归以及相加模型分析影响早期EC保留生育功能治疗后复发的危险因素及其交互作用。结果58例早期EC患者经治疗后均已达到完全缓解,其中16例出现治疗后复发,42例未出现复发,复发率为27.59%(16/58)。2组患者体质量指数、病灶直径以及是否使用促排卵药物比较差异均有统计学意义(χ^(2)=13.110,P<0.001;χ^(2)=9.166,P=0.002;χ^(2)=8.133,P=0.004)。体质量指数≥25 kg/m^(2)(OR=13.316,95%CI:2.734~23.899)、病灶直径≥2 cm(OR=6.773,95%CI:1.225~12.322)、使用促排卵药物(OR=32.983,95%CI:1.354~64.613)是早期EC患者保留生育功能治疗后复发的危险因素。早期EC患者保留生育功能治疗后复发的危险因素之间存在相加交互作用,体质量指数≥25 kg/m^(2)与病灶直径≥2 cm、体质量指数≥25 kg/m^(2)与使用促排卵药物、病灶直径≥2 cm与使用促排卵药物的交互作用指数分别为2.836、3.609、2.626,超额相对危险度分别为6.936、12.384、5.653。结论体质量指数≥25 kg/m^(2)、病灶直径≥2 cm、使用促排卵药物是早期EC患者保留生育功能治疗后复发的危险因素,且危险因素间具有正向交互作用。Objective To explore the association between the interaction of high body mass index and the use of ovulation stimulating drugs and the risk of relapse after fertility preservation therapy of endometrial cancer(EC).Methods Fifty-eight patients with early EC who received fertility preservation therapy in Heping Hospital of Changzhi Medical College from January 2021 to January 2023 were selected,all the patients achieved complete remission after progesterone combined with hysteroscopy.Clinical data of patients were collected and analyzed.Univariate,multivariate Logistic regression and additive models were used to analyze the risk factors and their interactions for relapse after early EC fertility preservation therapy.Results All the 58 patients with early EC achieved complete remission after treatment,of which 16 had relapse after treatment and 42 had no relapse,with a recurrence rate of 27.59%(16/58).The results of univariate analysis showed that there were significant differences in body mass index,lesion diameter and whether ovulation promoting drugs were used between the two groups(χ^(2)=13.110,P<0.001;χ^(2)=9.166,P=0.002;χ^(2)=8.133,P=0.004).Multivariate Logistic regression analysis showed that body mass index≥25 kg/m^(2)(OR=13.316,95%CI:2.734~23.899),lesion diameter≥2 cm(OR=6.773,95%CI:1.225~12.322)and use or no of ovulation stimulating drugs(OR=32.983,95%CI:1.354~64.613)were risk factors for relapse after fertility preservation therapy in early EC patients.There was a additive interaction between risk factors for relapse after fertility preservation therapy in early EC patients.The interaction indexes of body mass index≥25 kg/m^(2) with lesion diameter≥2 cm,body mass index≥25 kg/m^(2) with ovulation stimulating drugs,and lesion diameter≥2 cm with ovulation stimulating drugs were 2.836,3.609 and 2.626,respectively.The relative risk ratios of excess were 6.936,12.384 and 5.653,respectively.Conclusion Body mass index≥25 kg/m^(2),lesion diameter≥2 cm and use of ovulatory drugs are risk factors

关 键 词：早期子宫内膜癌 生育功能 体质量指数 促排卵药 复发风险 

分 类 号：R737.33[医药卫生—肿瘤]