摘要
目的 探讨淋巴脉管间隙浸润(LVSI)对早期子宫内膜样癌预后的影响。方法 回顾性分析2014年1月至2020年12月于郑州大学第二附属医院经手术治疗的262例ⅠA~ⅠB期子宫内膜样癌患者资料,失访9例,有完整资料者253例,其中ⅠA期208例,ⅠB期45例。分为LVSI阴性组(215例)和LVSI阳性组(38例),分析LVSI对早期子宫内膜样癌预后的影响。结果 全组对象5年总生存(OS)率为94.9%,5年无瘤生存(DFS)率为91.3%。单因素分析显示:除LVSI外,年龄≥60岁、组织学分级、深肌层浸润、腹水细胞学阳性和术后治疗也是5年OS率和DFS率的影响因素;COX多因素分析显示:年龄≥60岁、组织学分级是5年OS率、DFS率的独立影响因素,LVSI是5年OS率的独立影响因素,腹水细胞学阳性是5年DFS的独立影响因素。比较两组间的临床病理特征,单因素分析显示,LVSI与糖尿病、BMI、腹水细胞学结果、组织学分级和肌层浸润深度有关(P<0.05),logistic回归分析显示LVSI与糖尿病、组织学分级和深肌层浸润有关(P<0.05)。结论 LVSI与多种临床病理因素相关,影响早期子宫内膜样癌患者的生存和复发,LVSI是5年OS率的独立影响因素,不能确定LVSI是5年DFS率的独立影响因素。
Objective To explore the influence of the lymphovascular space invasion(LVSI)on the prognosis of early stage endometrial carcinoma.Methods Retrospective analysis was performed on 262 patients with stageⅠA toⅠB endometrial carcinoma who underwent surgical treatment in the Second Affiliated Hospital of Zhengzhou University from January 2014 to December 2020.Nine cases were lost to follow-up.There were 253 cases with complete data,including208 cases in stageⅠA and 45 cases in stageⅠB.The patients were divided into LVSI negative group(215 cases)and LVSI positive group(38 cases)and analyze the effect of LVSI on the prognosis of early endometrial carcinoma.Results The 5-year overall survival(OS)rate of the whole group was 94.9%and the 5-year disease free survival(DFS)rate was 91.3%.Univariate analysis showed that LVSI,age≥60 years old,histological grade,deep myometrial invasion,peritonic cytogenetic being positive and postoperative treatment were significantly related to the 5-year overall survival and disease free survival.The COX multivariate analysis showed that age≥60 years old and histological grade were independent factors for 5-year OS and DFS;LVSI was independent influencing factor of 5-year OS,peritonic cytogenetic being positive was independent influencing factor of 5-year DFS.The clinicopathological features were compared between the two groups,andunivariate analysis showed that LVSI was associated with diabetes,body mass index(BMI),histological grade,peritonic cytogenetic results and deep myometrial invasion(P<0.05);the factors associated with positive LVSI were diabetes,histological grade and deep myometrial invasion by the logistic regression analysis(P<0.05).Conclusion The presence of LVSI is related to many clinicopathological factors,which affects survival and disease recurrence in patients with early endometrioid carcinoma.LVSI is an independent influencing factor for 5-year OS.Whether LVSI is an independent influencing factor for 5-year disease free survival of early stage endometrical ca
作者
贾晴晴
徐臻
王利君
王武亮
JIA Qing-qing;XU Zhen;WANG Li-jun;WANG Wu-liang(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2022年第6期646-649,共4页
Chinese Journal of Practical Gynecology and Obstetrics
基金
河南省科技攻关项目(222102310618)。
关键词
子宫内膜癌
淋巴脉管间隙浸润
生存分析
预后
endometrial carcinoma
lymphovascular space invasion
survival analysis
prognosis
