摘要
目的 :探讨子宫内膜癌患者中的各临床病理因素与腹膜后淋巴结转移的关系 ,及腹膜后淋巴结切除术在子宫内膜癌治疗中的作用。方法 :分析1988年至1993年经手术治疗的子宫内膜癌196例 ,分别比较各项临床病理因素与淋巴结转移的发生率 ,比较腹膜后淋巴结阳性与阴性的5年生存率 ,在早期病例中比较腹膜后淋巴结清扫与可疑处多点活检者两组的5年生存率。结果 :各高危因素(浸润肌层≥1/2 ,G3 ,腺鳞癌)的腹膜后淋巴结转移率明显升高,Ⅰ期低危者腹膜后淋巴结阳性率小于5 %。腹膜后淋巴结阳性5年生存率明显低于阴性者。淋巴结清扫与活检两组的5年生存率无明显差异。结论 :子宫内膜癌的临床分期与手术分期差别大 ,腹膜后淋巴结切除对估计淋巴结转移及指导辅助治疗有意义。Ⅰ期低危者腹膜后淋巴结转移率低 ,不需施行淋巴结切除 ,而高危者有必要行腹膜后淋巴结切除。
Objective: To explore the relationship between the various clinicopathological factors and retroperitoneal metastases of lymph nodes. Methods: From 1988 to 1998, 196 cases of operated endometrial carcinoma were studied. Comparisons were carried out between various clinicopathologic factors and incidence of retroperitoneal metastases of lymph nodes; as well as the 5-year survival rates between positive and negative lymphadenopathy and in cases with lymphadenectomy and node sampling at suspicious sites. Results: The number of positive nodes increased significantly in high risk cases (deep myoinvasion, G3 and adenosquamous carcinoma ) than that of lower-risk cases. Less than 5% cases with positive node were found in low-risk stage Ⅰ cases. Five year survival rate decreased significantly in positive node cases than that in negative node cases. No significant difference was found between cases with retroperitoneal lymphadenectomy and node sampling. Conclusion: Retroperitoneal positive nodes are an important prognostic factor in endometrial carcinoma. There is great difference between the clinical staging and surgical staging. Nodes dissection have therapeutic significance in evaluating lymphatic metastasis and guiding to select adjuvant therapy. It is unnecessary to perform retroperitoneal lymph nodes dissection for low-risk stage Ⅰ cases because of low incidence of positive nodes, but it is necessary to do the procedure for high risk case.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2000年第6期426-428,共3页
Chinese Journal of Clinical Oncology
关键词
子宫内膜癌
腹膜后淋巴结转移
腹膜后淋巴切除
Endometrial carcinoma Prognostic factors Lymphatic metastasis Retroperitoneal lymph node Dissection Lymphadenectomy
