基础医学与临床 ›› 2016, Vol. 36 ›› Issue (6): 840-845.

• 临床园地 • 上一篇    下一篇

子宫内膜癌淋巴结转移及临床病理因素与预后的相关性

佐晶1,安菊生2,宋艳2,李卓2,张蓉2,李斌2,吴令英1   

  1. 1. 中国医学科学院 北京协和医学院 中国医学科学院肿瘤医院 妇瘤科
    2. 中国医学科学院 北京协和医学院 肿瘤医院
  • 收稿日期:2016-03-22 修回日期:2016-04-20 出版日期:2016-06-05 发布日期:2016-05-27
  • 通讯作者: 吴令英 E-mail:wulingying@csco.org.cn

Correlations among lymph node metastasis, clinical pathological features and prognosis in endometrial carcinoma

  • Received:2016-03-22 Revised:2016-04-20 Online:2016-06-05 Published:2016-05-27

摘要: 目的 研究子宫内膜癌的淋巴结转移等临床病理因素与预后的关系。方法 回顾性分析105例术后病理证实存在淋巴结转移的子宫内膜样腺癌患者的临床病理资料,分析盆腔淋巴结(髂总、髂内、髂外、闭孔淋巴结)转移、腹主动脉旁淋巴结转移、肿瘤位置、分化程度、肌层受侵、淋巴血管间隙浸润(lymph vascular space invasion,LVSI)、雌孕激素受体表达等因素对总生存期(overall survival,OS)和无病生存期(disease free survival, DFS)的影响。结果 存在子宫外受侵的患者更易发生腹主动脉旁淋巴结转移(P < 0.01);肌层受侵、子宫外受侵、腹腔冲洗液细胞学检查阳性与患者的OS、DFS缩短密切相关(P < 0.05)。结论 肿瘤侵犯至子宫外的患者更易发生腹主动脉旁淋巴结转移;肌层受侵、子宫外受侵、腹腔冲洗液细胞学检查阳性是子宫内膜癌的独立预后不良因素。

关键词: 子宫内膜癌, 淋巴结转移, 预后

Abstract: Objective To investigate the relationship between lymph node metastasis, clinical pathological features and prognosis of endometrial carcinoma. Methods One hundred and five patients were enrolled in this retrospective study. They were pathologically diagnosed as endometrioid endometrial cancer (EEC) with pelvic and/or para-aortic lymph node metastasis. Clinical and pathological data analysis showed pelvic lymph nodes (iliac, internal iliac, external iliac, obturator lymph nodes) and para-aortic lymph node metastasis, tumor location, tumor differentiation, myometrial invasion, lymph vascular space invasion, estrogen and progesterone receptor expressions have important impacts on OS (overall survival) and DFS (disease free survival). Results Patients with invasion beyond the uterus were more likely to have para-aortic lymph node metastasis(P < 0.01). Myometrial invasion, external Invasion of Uterus and peritoneal cytology positive were related to shortened OS and DFS(P < 0.05). Conclusions The patients with tumor invasion beyond the uterus are more likely to have paraaortic lymph node metastasis. myometrium involvement, involvement outside the uterus and peritoneal cytology positive are indepedent negative prognosis factors in endometrial cancer.

Key words: endometrial carcinoma, lymph node metastasis, prognosis

中图分类号: