基础医学与临床 ›› 2017, Vol. 37 ›› Issue (4): 443-447.

• 子宫内膜癌专题 • 上一篇    下一篇

年轻早期子宫内膜癌患者保留卵巢的安全性及预后

王永学1,金滢2,2,李艳2,潘凌亚3   

  1. 1. 中国医学科学院 北京协和医学院 北京协和医院妇产科
    2. 北京协和医院妇产科
    3. 中国医学科学院 北京协和医学院 北京协和医院
  • 收稿日期:2017-02-23 修回日期:2017-02-27 出版日期:2017-04-05 发布日期:2017-03-24
  • 通讯作者: 王永学 E-mail:wangyongxuepumch@gmail.com

Safety and prognosis of ovarian preservation in young women with early-stage endometrial cancer

Yong-xue WANG1, 2,2, Ling-ya PAN   

  • Received:2017-02-23 Revised:2017-02-27 Online:2017-04-05 Published:2017-03-24
  • Contact: Yong-xue WANG E-mail:wangyongxuepumch@gmail.com

摘要: 目的 探讨年轻的I期子宫内膜癌患者保留卵巢的安全性及预后。方法 回顾性分析北京协和医院2005年1月至2011年12月间接受手术治疗的年龄≤45岁的I期子宫内膜癌患者的临床病理资料。根据术中是否保留卵巢分为保留卵巢组和切除卵巢组,比较分析两组的临床病理特征及预后。结果 研究共纳入患者72例,其中保留卵巢组25例(34.7%),切除卵巢组47例(65.3%)。保留卵巢组患者与切除卵巢组患者相比更年轻(P=0.007),并且接受淋巴结切除的比例明显低于保留卵巢组患者(P<0.001)。两组患者在分期、肿瘤分级、肌层浸润深度以及术后辅助治疗方面均无统计学差异(P>0.05)。72例患者的中位随诊时间为89个月(7~131月),共有5例患者复发,没有患者死亡。Kaplan-Meier生存曲线及log rank检验显示两组的无复发生存时间无差异(P=0.194)。COX风险回归分析发现保留卵巢对无复发生存期无影响(HR=3.08,95%CI 0.54-18.44)。结论 年轻的早期子宫内膜癌患者保留卵巢是安全的,对患者的无复发生存时间无显著影响。

关键词: 子宫内膜癌, 保留卵巢, 预后

Abstract: Objective The aim of this study was to evaluate the safety and prognosis of ovarian preservation in young women with early-stage endometrial cancer. Methods Women≤45 years of age with stageⅠendometrial cancer recorded from Jan 2005 to Dec 2011 in Peking Union Medical College Hospital were examined. They were further divided into two groups: ovarian preservation group and oophorectomy group. Clinical and pathological recording of these patients were compared. Results A total of 72 women, including 25 patients (34.7%) who had ovarian preservation, were identified. The ovarian preservation group was younger (P=0.007) and had a lower prevalence of lymphadenectomy (P<0.001). While there were no significant difference in stage, tumor grade, the invasion depth of myometrium and adjuvant treatment between two groups (all P>0.05). Of seventy-two cases, five patients relapsed and all survived after a median follow-up time of 89 months (rang: 7-131 months). The Kaplan-Meier curve and the log rank test showed no difference in recurrence-free survival (P=0.194). In Cox model analysis, ovarian preservation had no effect on recurrence-free survival (HR=3.08, 95% CI 0.54-18.44). Conclusions Ovarian preservation in young women with early-stage endometrial cancer is safe and has no negative effect on recurrence-free survival or overall survival.

Key words: endometrial cancer, ovarian preservation, prognosis

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