Ⅱ~Ⅲ期子宫内膜癌腹腔镜根治术中腹主动脉淋巴结清扫方案对血清CA125、CA199水平及无瘤生存时间的影响  

Influence of the abdominal aortic lymph node dissection regimen during laparoscopic radical resection of patients with endometrial cancer stageⅡ-Ⅲon their levels of the serum carbohydrate antigen 125 and arbohydrate antigen 199 and their tumor-free sur

作　　者：袁爱君 危钰辉 何健英[1] YUAN Aijun;WEI Yuhui;HE Jianying(Jinhua People's Hospital,Jinhua,Zhejiang Province,321000;The First Affiliated Hospital of Anhui University of Science and Technology(Huainan First People's Hospital),Huainan,Anhui Province)

机构地区：[1]浙江省金华市人民医院,321000 [2]安徽理工大学第一附属医院,淮南市第一人民医院

出　　处：《中国计划生育学杂志》2025年第4期925-929,934,共6页Chinese Journal of Family Planning

基　　金：金华市中医药科学技术研究计划项目(2022KY10)。

摘　　要：目的:探究Ⅱ~Ⅲ期子宫内膜癌患者腹腔镜根治术中腹主动脉淋巴结清扫方案对其血清糖类抗原125(CA125)、糖类抗原199(CA199)水平及无瘤生存时间的影响。方法:回顾性分析2017年6月-2019年1月于金华市人民医院和安徽理工大学附属第一医院接受腹腔镜根治术治疗的Ⅱ~Ⅲ期子宫内膜癌患者临床资料,根据淋巴结清扫方案不同分为对照组和观察组,对照组实施单纯盆腔淋巴结清扫方案,观察组实施盆腔+腹主动脉旁淋巴结清扫方案,经倾向性匹配排除性别、年龄、肿瘤分期等混杂因素,最终获得53对患者。比较两组一般资料、手术相关指标、围术期并发症发生情况,比较两组术前及术后不同时期血清肿瘤标志物(CA125、CA199)水平,采用Kaplan-Meier生存曲线评估两组术后两年内无瘤生存期、生存期。结果:观察组手术时间长于对照组(P<0.05),两组围术期并发症总发生率无差异(P>0.05);术后3、6个月及末次随访时,两组血清CA125、CA199水平均低于术前且观察组低于对照组(均P<0.05)。Kaplan-Meier生存曲线分析,观察组平均无瘤生存时间(23.5个月)长于对照组(21.9个月),术后两年内无瘤生存率(92.5%)高于对照组(77.4%)(P<0.05)。结论:在Ⅱ~Ⅲ期子宫内膜癌患者腹腔镜根治术中运用盆腔+腹主动脉旁淋巴结清扫方案有良好的临床疗效,可有效抑制肿瘤生长,预防肿瘤复发,延长患者无瘤生存时间,且安全性良好。Objective:To explore the influence of the abdominal aortic lymph node dissection regimen during laparoscopic radical resection of patients with endometrial cancer stage II-III on their levels of the serum carbohydrate antigen 125(CA125)and arbohydrate antigen 199(CA199),and their tumor-free survival time.Methods:The clinical data of the patients with endometrial cancer stage II to III who underwent laparoscopic radical resection in the hospital between June 2017 and January 2019 were analyzed retrospectively.According to the different lymph node dissection regimens,these patients were divided into control group and observation group.The patients in the control group were given the pelvic lymph node dissection regimen,while the patients in the observation group were given pelvic and para-aortic lymph node dissection regimen.The propensity match was used to exclude the confounding factors,such as gender,age,tumor stage and other,and finally 53 pairs of patients were obtained in this study.The general data,the surgical-related indicators and the occurrence of perioperative complications of the patients were compared between the two groups.The levels of serum tumor markers(CA125 and CA199)of the patients before surgery and at different time periods after surgery were compared between the two groups.Kaplan-Meier survival curve was adopted to evaluate the tumor-free survival time and the survival time of the patients in the two groups within 2years after surgery.Results:The surgical time of the patients in the observation group was significantly longer than that of the patients in the control group(P<0.05).There was no significant difference in the total incidence of the perioperative complications of the patients between the two groups(P>0.05).The levels of the serum CA125and CA199of the patients in the two groups in 3and 6months after surgery and at the last follow-up were significantly lower than those of the patients before surgery(P<0.05),and which of the patients in the observation group were significantly lower

关 键 词：子宫内膜癌 腹腔镜根治术 腹主动脉淋巴结清扫 肿瘤标志物 无瘤生存时间 

分 类 号：R737.33[医药卫生—肿瘤]