摘要
目的探讨临床早期（Ⅰ-Ⅱ期）子宫内膜癌初治患者术后复发转移及预后的影响因素。方法回顾性分析2008年2月至2014年2月204例在湖南省肿瘤医院行手术治疗的Ⅰ-Ⅱ期子宫内膜癌患者的临床资料,随访截止日期2015年3月1日。记录复发转移情况,分析复发转移影响因素;采用Kaplan-Meier法计算生存率,预后影响因素的单因素分析采用Log-rank检验,多因素分析采用COX回归模型。结果 204例患者中有复发转移20例,复发转移率9.8%,其中有65.0%（13/20）的患者在5年内复发转移;在复发转移率方面：年龄超过50岁者明显高于年龄小于或等于50岁者,浆液性腺癌者高于子宫内膜样腺癌者,病理分级G3者高于G1-G2者,肌层浸润深度大于或等于1/2者高于无肌层浸润和肌层浸润深度小于1/2者,肿瘤长径超过2cm者高于小于或等于2cm者、腹水细胞学检查阳性者高于阴性者、ER阴性者高于阳性者、PR阴性者高于阳性者,差异有统计学意义（P〈0.05）;204例患者1、3、5年总生存率分别为100.0%、92.1%、84.3%。单因素分析结果显示,年龄、肿瘤长径、肌层浸润深度、病理类型、病理分级、腹水细胞学结果、ER、PR表达是Ⅰ-Ⅱ期子宫内膜癌患者预后的影响因素（P〈0.05）;COX回归分析结果显示,肌层浸润深度（OR=2.473,95%CI：1.322-5.982,P=0.002）、腹水细胞学结果（OR=3.456,95%CI：1.498-7.394,P=0.001）及病理类型（OR=3.764,95%CI：1.545-6.364,P=0.001）是预后的独立影响因素。结论高龄、肿瘤体积较大、肌层浸润较深、浆液性腺癌、病理分级较高、腹水细胞学阳性、ER阴性、PR阴性的Ⅰ-Ⅱ期子宫内膜癌初治患者术后容易复发转移,预后相对较差;复发转移多集中于术后5年内,对于此类高危患者在初治后5年内应加强随访。
Objective To explore the influence factors of postoperative recurrence,metastasis and prognosis in patients with early endometrial carcinoma（stageⅠ-Ⅱ）.Methods The clinical data of 204 cases patients with early endometrial carcinoma（stageⅠ-Ⅱ）treated by surgery from February 2008 to February 2014 in Hunan Provincial Tumor Hospital were retrospectively analyzed,and these patients were followed up until March 1,2015.The situations of recurrence and metastasis were recorded,and the influence factors were analyzed.Kaplan-Meier method was used to calculate the survival rate.Log-rank test was used for the univariate analysis of the influence factors of prognosis,and COX regression was used for the multivariate analysis.Results Among 204 cases of patients,there were20 cases with recurrence and metastasis（9.8%）,and 65.0%（13/20）of them occurred recurrence and metastasis within five years after surgery.The rates of recurrence and metastasis in patients50years old were higher than patients≤50years old,which in patients with serous adenocarcinoma were higher than patients with endometrial adenocarcinoma,which in patients of pathologic grade G3 were higher than patients of pathologic grade G1 and G2,which in patients with depth of myometrial invasion≥1/2were higher than patients with depth of myometrial invasion1/2and patients without myometrial invasion,which in patients with tumor diameter2cm were higher than patients with tumor diameter≤2cm,which in patients with positive ascites cytology were higher than patients with negative ascites cytology,which in patients with negative ER were higher than patients with positive ER,and which in patients with negative PR were higher than patients with positive PR,with statistical differences（P〈0.05）.1-,3-and 5-year overall survival rates of 204 patients respectively were 100.0%,92.1% and 84.3%.The results of univariate analysis showed that age,tumor diameter,pathological type,depth of muscular infiltration,pathologic grade,ascites cytology,ER and PR e
出处
《检验医学与临床》
CAS
2015年第24期3676-3678,3681,共4页
Laboratory Medicine and Clinic
关键词
子宫内膜癌
早期
手术
复发转移
预后
endometrial carcinoma
early
surgery
recurrence and metastasis
prognosis
