摘要
目的探讨子宫内膜癌淋巴结转移分布的规律及其与预后的关系。方法回顾性分析148例行腹膜后淋巴结清扫术的子宫内膜癌患者的临床病理资料,并随访患者生存情况。结果 148例患者中33例(22.3%)发生淋巴结转移,单独盆腔淋巴结转移19例(57.6%),单独腹主动脉旁淋巴结转移5例(15.2%),盆腔及腹主动脉旁淋巴结同时转移9例(27.3%),以闭孔淋巴结转移最常见。深肌层浸润和宫颈受累是导致淋巴结转移的独立危险因素(P<0.05),淋巴结转移、深肌层浸润以及淋巴结清扫数目是影响子宫内膜癌预后的独立因素(P<0.05),淋巴结清扫数目>22枚较≤22枚的患者死亡率高(26.9%和8.2%,P<0.05),淋巴结转移数目>3枚较≤3枚的患者死亡率高(50.0%和10.5%,P<0.05)。结论子宫内膜癌的转移途径可以先累及盆腔淋巴结,再转移至腹主动脉旁淋巴结,也可直接转移至腹主动脉旁淋巴结,以闭孔淋巴结最易转移;深肌层浸润和宫颈受累是导致淋巴结转移的独立危险因素;淋巴结清扫及转移的数目越多,预后越差。
Objective To explore lymph nodes metastasis（LNM） pattern of endometrial carcinoma and its relation- ship with patients＇ prognosis. Methods The clinicopathologie data of 148 patients with endometrial carcinoma undergone retroperitoneal lymphadeneetomy in Affiliated Tumor Hospital of Shantou University Medical College from Jun 1999 to Jun 2011 were analyzed retrospectively and the outcomes of patients were followed up. Results There were 33 cases had LNM. Among them, 19 cases（57.6;）had pelvic LNM, 5 cases（15.2%）had para-aortic LNM and 9 cases（27. 3%）had both. The most common site of LNM was obturator lymph nodes. Deep myometrial infiltration and cervical involvement were the independent risk factors of LNM （P;0. 05）. Three independent factors as LNM, deep myometrial infiltration and lymph nodes count were related to overall survival （P〈0. 05）. Lymph nodes number more than 22 and LNM number more than 3 meant worse prognosis. Conclusion Endometrial carcinoma can metastasize to para-aortic lymph nodes directly and indirectly from pelvic lymph nodes. The most common site of LNM was obturator lymph nodes. Deep myometrial infiltration and cervical involvement were the independent risk factors of LNM. The more number of lymph nodes dissection and metastasis, the worse prognosis the patient would have.
出处
《西部医学》
2013年第5期678-680,684,共4页
Medical Journal of West China
关键词
子宫内膜肿瘤
淋巴结转移
腹膜后淋巴结切除
预后
Endometrial neoplasm
Lymph nodes metastasis
Retroperitoneal lymphadeneetomy
Prognosis
