【摘要】：目的1.分析子宮內(nèi)膜癌卵巢轉(zhuǎn)移的危險因素并探討術(shù)中保留卵巢的可行性。2.分析子宮內(nèi)膜癌卵巢隱性轉(zhuǎn)移的危險因素。3.對于子宮內(nèi)膜癌卵巢轉(zhuǎn)移患者的臨床病理特征與子宮內(nèi)膜及卵巢原發(fā)性雙癌患者的臨床病理特征進行對比分析,為臨床鑒別診斷與治療提供理論依據(jù)。材料方法回顧性分析自1985年1月至2016年1月在天津醫(yī)科大學總醫(yī)院收治的788例子宮內(nèi)膜癌患者的臨床病理資料,所有患者均不合并其他部位惡性腫瘤,術(shù)前均未進行放療治療、化療以及激素治療。其中包括50例內(nèi)膜癌患者合并卵巢受累,50例患者包括41例子宮內(nèi)膜癌卵巢轉(zhuǎn)移患者和9例子宮內(nèi)膜及卵巢原發(fā)性雙癌患者。41例子宮內(nèi)膜癌卵巢轉(zhuǎn)移患者中,20例為顯性轉(zhuǎn)移,21例為隱性轉(zhuǎn)移。本研究采用spss19.0進行統(tǒng)計學分析,子宮內(nèi)膜癌卵巢轉(zhuǎn)移及卵巢隱性轉(zhuǎn)移的危險因素采用單因素及多因素logistic回歸分析,p0.05差異有顯著性;連續(xù)型變量描述采用平均值±標準差(?x±s)描述,子宮內(nèi)膜及卵巢原發(fā)性雙癌組與子宮內(nèi)膜癌卵巢轉(zhuǎn)移組之間的對比分析,當兩組例數(shù)≥40時,采用四格表的x2檢驗計算結(jié)果,當兩組例數(shù)40時,則采用Fisher確切概率法進行計算結(jié)果。兩組間計量資料用t檢驗。檢驗水準α=0.05。結(jié)果1.子宮內(nèi)膜癌卵巢轉(zhuǎn)移的臨床病理特征單因素回歸分析顯示輸卵管浸潤、病理類型及級別、子宮肌層浸潤深度、宮旁組織浸潤、盆腔淋巴結(jié)轉(zhuǎn)移、宮頸浸潤、血清CA125≥35U/m L、子宮漿膜浸潤與內(nèi)膜癌卵巢轉(zhuǎn)移存在相關(guān)性(p0.05);多因素logistic回歸分析顯示輸卵管浸潤、宮旁浸潤、血清CA125≥35U/m L是內(nèi)膜癌卵巢轉(zhuǎn)移的獨立危險因素;2.子宮內(nèi)膜癌卵巢隱性轉(zhuǎn)移單因素回歸分析示輸卵管浸潤、病理類型、子宮肌層浸潤深度、病理級別、宮旁浸潤、盆腔淋巴結(jié)轉(zhuǎn)移、血清CA125≥35U/m L及腹水或腹腔沖洗液細胞學陽性與卵巢隱性轉(zhuǎn)移存在相關(guān)性,多因素logistic回歸分析未發(fā)現(xiàn)與隱性轉(zhuǎn)移的相關(guān)危險因素;3.子宮內(nèi)膜及卵巢原發(fā)性雙癌組與子宮內(nèi)膜癌卵巢轉(zhuǎn)移組關(guān)于腫瘤級別、卵巢腫瘤的大小的因素差異有統(tǒng)計學意義(p0.05),子宮內(nèi)膜及卵巢原發(fā)性雙癌組相對于子宮內(nèi)膜癌卵巢轉(zhuǎn)移組,腫瘤級別較低,卵巢腫物直徑較大。結(jié)論1.輸卵管浸潤、宮旁浸潤及血清CA125≥35U/m L是子宮內(nèi)膜癌卵巢轉(zhuǎn)移的獨立危險因素。2.輸卵管浸潤、病理類型、肌層浸潤深度、病理級別、宮旁浸潤、盆腔淋巴結(jié)轉(zhuǎn)移、血清CA125≥35U/m L及腹水或腹腔沖洗液細胞學陽性與卵巢隱性轉(zhuǎn)移存在相關(guān)性。3.子宮內(nèi)膜及卵巢原發(fā)性雙癌患者相對于子宮內(nèi)膜癌卵巢轉(zhuǎn)移患者的內(nèi)膜病灶病理級別較低,卵巢腫瘤直徑相對較大。
[Abstract]:Objective 1. To analyze the risk factors of ovarian metastasis in endometrial carcinoma and to explore the feasibility of ovarian preservation during operation. 2. To analyze the risk factors of ovarian recessive metastasis in endometrial carcinoma. The clinicopathological features of patients with ovarian metastasis from endometrial carcinoma were compared with those of patients with primary double carcinoma of endometrium and ovary, which provided a theoretical basis for clinical differential diagnosis and treatment. Methods from January 1985 to January 2016, 788 patients with endometrial carcinoma treated in the General Hospital of Tianjin Medical University were retrospectively analyzed. Chemotherapy and hormone therapy. These included 50 cases of endometrial carcinoma with ovarian involvement, 50 cases of endometrial carcinoma with ovarian metastasis and 9 cases of primary endometrial and ovarian double carcinoma. There were 20 cases of dominant metastasis and 21 cases of recessive metastasis. In this study, spss19.0 was used to analyze the risk factors of ovarian metastasis and recessive metastasis of endometrial carcinoma by univariate and multivariate logistic regression analysis. The mean 鹵standard deviation (? x 鹵s) was used to describe the continuous variable. The comparative analysis was made between the primary double carcinoma of endometrium and ovary and the ovarian metastasis of endometrial carcinoma, when the number of cases in the two groups was more than 40. The results are calculated by using the x2 test of the four-grid table, and when the number of the two groups of cases is 40, the exact probability method of Fisher is used to calculate the results. The metrological data between the two groups were tested by t test. The test level is 偽 = 0.05. Result 1. Single factor regression analysis showed fallopian tube invasion, pathological type and grade, depth of myometrium invasion, periuterine tissue infiltration, pelvic lymph node metastasis, cervix invasion, serum CA125 鈮，

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