本文關(guān)鍵詞： 子宮內(nèi)膜癌 卵巢轉(zhuǎn)移 保留卵巢 影響因素　出處：《廣西醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：研究子宮內(nèi)膜癌患者卵巢轉(zhuǎn)移的臨床病理特點(diǎn)、影響因素及其意義，探討子宮內(nèi)膜癌保留卵巢的適應(yīng)證及可行性。 資料與方法：本文收集2007年1月至2013年12月在廣西醫(yī)科大學(xué)第四附屬醫(yī)院婦科就診且臨床資料完整的子宮內(nèi)膜癌患者206例，所有患者均行手術(shù)治療，并按照國際婦產(chǎn)科聯(lián)盟（International Federation ofGynecology and Obstetrics，，F(xiàn)IGO）2009年修訂的子宮內(nèi)膜癌手術(shù)-病理分期標(biāo)準(zhǔn)分期或再分期�；仡櫺苑治�206例子宮內(nèi)膜癌患者的年齡、臨床表現(xiàn)、孕產(chǎn)史、術(shù)前CA-125檢查、確診途徑、術(shù)前臨床分期、手術(shù)方式、手術(shù)范圍、手術(shù)-病理分期、病理類型、組織分級、卵巢轉(zhuǎn)移等情況；單因素及多因素分析子宮內(nèi)膜癌卵巢轉(zhuǎn)移的影響因素。應(yīng)用SPSS17.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析，單因素分析采用χ2檢驗(yàn)，多因素分析采用Logistic回歸模型分析。 結(jié)果：1、子宮內(nèi)膜癌平均發(fā)病年齡52.43±8.48歲，206例患者中已絕經(jīng)者100例，占48.54%。2、子宮內(nèi)膜癌以不規(guī)則陰道流血或流液為主要癥狀者有192例，占93.20%。其中絕經(jīng)后陰道流血88例。3、卵巢轉(zhuǎn)移者15例，占7.28%，其中雙側(cè)卵巢轉(zhuǎn)移8例，占卵巢轉(zhuǎn)移的53.33%。所有卵巢轉(zhuǎn)移者術(shù)中卵巢大小正常，外觀無異常者10例。4、單因素分析結(jié)果提示低分化、肌層浸潤深度≥1/2、宮頸受累、盆腔淋巴結(jié)陽性、腫瘤標(biāo)記物CA125陽性、脈管癌栓陽性、術(shù)前臨床分期高的患者的卵巢轉(zhuǎn)移率顯著升高（p0.05），是子宮內(nèi)膜癌卵巢轉(zhuǎn)移的影響因素。年齡、病理類型、組織中/高分化以及腹主動脈旁淋巴結(jié)陽性對子宮內(nèi)膜癌卵巢轉(zhuǎn)移無顯著影響（p0.05）。5、多因素分析結(jié)果提示低分化、腫瘤標(biāo)志物CA-125陽性是子宮內(nèi)膜癌卵巢轉(zhuǎn)移的獨(dú)立影響因素(p0.05)，OR值依次為2.095、4.170。 結(jié)論： 1、子宮內(nèi)膜癌卵巢轉(zhuǎn)移率為7.28%（15/206），雙側(cè)卵巢轉(zhuǎn)移率為3.88%（8/206）。 2、低分化、肌層浸潤深度≥1/2、宮頸受累、盆腔淋巴結(jié)陽性、腫瘤標(biāo)記物CA-125陽性、脈管癌栓陽性、術(shù)前臨床分期高為子宮內(nèi)膜癌卵巢轉(zhuǎn)移的影響因素。 3、腫瘤標(biāo)志物CA-125陽性、低分化是子宮內(nèi)膜癌卵巢轉(zhuǎn)移的重要獨(dú)立影響因素。 4、子宮內(nèi)膜癌卵巢轉(zhuǎn)移多為存在高危因素者，若為高分化子宮內(nèi)膜樣腺癌、無深肌層浸潤、無宮頸受累及脈管癌栓、無淋巴結(jié)轉(zhuǎn)移，且腫瘤標(biāo)志物CA125正常的臨床Ⅰ期患者，經(jīng)嚴(yán)格術(shù)前評估及術(shù)中廣泛探查，可考慮保留一側(cè)或雙側(cè)卵巢，術(shù)后需嚴(yán)密隨訪。但此研究為回顧性研究，仍需要多中心、大樣本的前瞻性隨機(jī)對照試驗(yàn)來論證。
[Abstract]:Objective: to study the clinicopathological features, influencing factors and significance of ovarian metastasis in endometrial carcinoma, and to explore the indications and feasibility of ovarian preservation in endometrial carcinoma. Materials and methods: from January 2007 to December 2013, 206 cases of endometrial carcinoma with complete clinical data were collected from 4th affiliated Hospital of Guangxi Medical University. According to the standard staging or re-staging of endometrial carcinoma, which was revised by International Federation ofGynecology and Obstetrics Figo on 2009, the age, clinical manifestation, history of pregnancy and childbirth and preoperative CA-125 examination of 206 patients with endometrial carcinoma were retrospectively analyzed. The way of diagnosis, preoperative clinical stage, operation mode, operation range, operation-pathological stage, pathological type, histological grade, ovarian metastasis and so on; Univariate and multivariate analysis was used to analyze the influencing factors of ovarian metastasis of endometrial carcinoma. SPSS17.0 software was used for statistical analysis, 蠂 2 test for univariate analysis and Logistic regression model for multivariate analysis. Results the mean age of onset of endometrial carcinoma was 52.43 鹵8.48 years old. 100 cases were menopausal, accounting for 48.54.2.192 cases of endometrial carcinoma were characterized by irregular vaginal bleeding or fluid flow. There were 88 cases of postmenopausal vaginal bleeding, 15 cases of ovarian metastasis (7.28%), and 8 cases of bilateral ovarian metastasis, accounting for 53.33% of ovarian metastasis. The results of univariate analysis showed that the myometrial invasion depth 鈮

本文編號：1542041