本文選題：子宮內(nèi)膜腫瘤 + 淋巴轉(zhuǎn)移��； 參考：《醫(yī)學(xué)研究生學(xué)報(bào)》2015年07期

【摘要】：目的低級(jí)別子宮內(nèi)膜癌患者淋巴結(jié)轉(zhuǎn)移的特征以及淋巴結(jié)轉(zhuǎn)移對(duì)患者預(yù)后的影響,目前還存在一些爭(zhēng)議。文中旨在探討低級(jí)別子宮內(nèi)膜癌患者的淋巴結(jié)轉(zhuǎn)移特征、高危因素及其對(duì)預(yù)后的影響,為制定手術(shù)方案提供參考依據(jù)。方法選取新疆醫(yī)科大學(xué)附屬腫瘤醫(yī)院2006年1月1日至2011年1月1日收治的218例行腹膜后淋巴結(jié)清掃術(shù)的低級(jí)別子宮內(nèi)膜癌患者,根據(jù)術(shù)后病理分析淋巴結(jié)轉(zhuǎn)移特征,并根據(jù)長(zhǎng)期隨訪結(jié)果分析淋巴結(jié)轉(zhuǎn)移與患者生存期的關(guān)系。結(jié)果 1淋巴結(jié)轉(zhuǎn)移特征:淋巴結(jié)轉(zhuǎn)移率為16.97%(37/218),其中主要僅轉(zhuǎn)移至髂外淋巴結(jié)和閉孔淋巴結(jié)者20例(54.05%),僅轉(zhuǎn)移至腹主動(dòng)脈旁淋巴結(jié)者6例(16.22%),同時(shí)轉(zhuǎn)移至盆腔及腹主動(dòng)脈旁淋巴結(jié)者11例(29.73%)。2低級(jí)別子宮內(nèi)膜癌淋巴結(jié)轉(zhuǎn)移影響因素分析結(jié)果顯示:深肌層浸潤(rùn)(OR:5.21,95%CI:2.77~9.81)、脈管癌栓(OR:1.15,95%CI:1.02~1.30)、宮頸間質(zhì)受累(OR:3.15,95%CI:1.12~8.35)及CA125升高(OR:3.46,95%CI:1.56~7.67)是淋巴結(jié)轉(zhuǎn)移的影響因素(P0.05)。3低級(jí)別子宮內(nèi)膜癌淋巴結(jié)轉(zhuǎn)移的預(yù)后顯示:有、無(wú)淋巴結(jié)轉(zhuǎn)移的3年生存率分別為83.8%、95.0%;3年無(wú)瘤生存率分別為73.0%、90.1%,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論深肌層浸潤(rùn)、脈管癌栓、宮頸間質(zhì)受累和血清CA125值較高的低級(jí)別子宮內(nèi)膜癌患者易發(fā)生淋巴結(jié)轉(zhuǎn)移,有淋巴結(jié)轉(zhuǎn)移的患者預(yù)后較差。
[Abstract]:Objective the characteristics of lymph node metastasis in low grade endometrial carcinoma and the influence of lymph node metastasis on prognosis are still controversial. The purpose of this study was to investigate the characteristics of lymph node metastasis, high risk factors and their influence on prognosis in patients with low grade endometrial carcinoma. Methods 218 patients with low grade endometrial carcinoma treated by retroperitoneal lymph node dissection from January 2006 to January 1, 2011 in affiliated Cancer Hospital of Xinjiang Medical University were selected, and the characteristics of lymph node metastasis were analyzed according to postoperative pathology. The relationship between lymph node metastasis and survival time was analyzed according to long-term follow-up. Results 1 characteristics of lymph node metastasis: the lymph node metastasis rate was 16.97% 37 / 218g, of which only 20 cases were mainly transferred to external iliac lymph nodes and obturator lymph nodes, 6 cases to the lymph nodes adjacent to the abdominal aorta, and to pelvic and abdominal active metastasis. Analysis of influencing factors of lymph Node Metastasis in 11 cases of Peripheral lymph Node with low grade endometrial carcinoma. The results showed that the invasion of deep myometrium was OR 5.21 ~ 95 CI: 2.77 ~ 9.81%, OR: 1.15 ~ 95 CI: 1.02T 1.30, cervix interstitial involvement OR3.1595 CI1.128.35) and CA125 increased ORW 3.4695 CIW 1.566.7.67) were the influencing factors of lymph node metastasis. The prognosis of lymph node metastasis in other endometrial carcinoma is: yes, The 3-year survival rate of lymph node metastasis was 83.8% and that of tumor free group was 73.0% and 90.1%, respectively. The difference was statistically significant (P 0.05). Conclusion low grade endometrial carcinoma patients with deep muscle invasion, vascular tumor embolus, cervical interstitial involvement and high serum CA125 are prone to lymph node metastasis, and the prognosis of patients with lymph node metastasis is poor.
【作者單位】： 新疆醫(yī)科大學(xué)附屬腫瘤醫(yī)院婦外五科;
【基金】：新疆醫(yī)科大學(xué)“天山英才工程”項(xiàng)目(Y0231021)
【分類號(hào)】：R737.33
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本文編號(hào)：1806602