子宫内膜癌盆腔淋巴结的临床病理特征分析.doc

子宫内膜癌盆腔淋巴结的临床病理特征分析
【摘要】
目的研究分析子宫内膜癌患者盆腔淋巴结转移的相关因素及盆腔淋巴清扫术对预后的影响。方法对71例各期子宫内膜癌患者的手术治疗、不同临床病理指标及预后进行回顾性分析。结果71例子宫内膜癌患者淋巴结转移与病理分级(P＜0.05)、肌层浸润深度（P＜0.01）、宫颈累及（P＜0.01）、腹腔冲洗液可见癌细胞（P＜0.01）、宫旁或附件累及（P＜0.01）均相关，与癌灶累及宫腔面积超过50%或有子宫腔下段及峡部受累者(P>0.05)、年龄（P>0.05）、病理类型（P>0.05）均无相关;淋巴结没有转移患者的生存率明显高于已有转移的患者(P＜0.01)。多因素分析显示淋巴结转移以及盆腔淋巴清扫术均不是子宫内膜癌独立的预后影响因素。结论病理分化程度低、深肌层浸润、宫颈浸润、宫旁或附件浸润、腹腔冲洗液细胞学检查阳性是子宫内膜癌盆腔淋巴结转移的高危因素,有盆腔淋巴结转移的患者预后较差。
【关键词】子宫内膜肿瘤淋巴结转移预后
Correlationbetweenendometrialcarcinomapelviclymphnodesmetastasesandclinicalpathologiccharacteristicsanditsclinicalsignificance.
HUChun-xia,JINSong,LINGYi,etal.
(AffiliatedHospitalofHainanMedicalCollege,Haikou570102,Hainan,P.R.China)

Abstract：ObjectiveToanalyzethefactorsassociatedwithpelviccavitylymphnodemetastasesinendometrialcarcinomaandclinicalpathologiccharacteristicsanditsclinicalsignificanceandprognosisafterpelviclymphadenectemy.MethodsSurgicaltreatment,clinicalpathologicalcriteriasandprognosisof71casesofendometrialcarcinomaindifferentstageswerestudiedretrospectively.Results1.Amongthe71endometrialcarcinomacasesthelymphnodemetastasesweresignificantlyassocaitedwiththepathologicalclassification(P<0.05),infiltrationdepthofmuscularlayer（P＜0.01),cervicalinvasion(P<0.01),presentofcarcinomacellsinpelvicwashingfluid(P<0.01)andinvasionofparacervicalligmentsoraffiliates(P<0.01),butnotrelatedwiththepatients&rsquo;ageandpathologictypeandtheinvasionlesiontotheuterinecavity>50%orcavitaryuteriinferiorsegmentandisthmusuteriinfiltration.2.Thesurvivalratewassignificantlyhigherinthepatientswithoutlymphnodemetastasesthanthosewithlymphnodemetastases(P<0.01),multifactoranalysisshowedthatneitherlymphnodemetastasesnorpelviclymphadenectemywasanindependentfactorthatinfluencedtheprognosis.ConclusionLowpathologicclassification,deepinfiltrationofmuscularlayer,cervixinvasion,paracervicalligmentsoraffiliates,positivecellfindinginpelvicwashingfluidarehighriskfactorsassoicatedwithpelviclymphnodemetastasesofendometrialcarcinoma.Theprognosisofpatientswithpelviclymphno