摘要
目的研究淋巴血管间隙浸润(LVSI)的子宫内膜癌的临床病理特征,以及与预后的相关性。方法回顾性分析2007年1月~2017年12月在南京鼓楼医院治疗的671例子宫内膜癌患者的病例资料,其中LVSI阳性组120例,LVSI阴性组551例;分析患者的临床病理信息,建立Kaplan-Meier曲线,并进行单因素和多因素分析。结果与LVSI阴性组比较,LVSI阳性组已绝经、手术病理期别晚、深肌层浸润、组织分化差、伴淋巴结转移、发生复发及死亡患者占比升高,差异有统计学意义(P<0.05);两组有内科合并症(高血压、糖尿病)或子宫肌瘤患者占比比较,差异无统计学意义(P>0.05)。多因素分析结果显示,宫颈间质累及(OR=0.342,95%CI:0.134~0.873,P<0.05)、LVSI(OR=0.110,95%CI:0.051~0.238,P<0.01)与淋巴结转移显著相关;生存率分析结果表明,在LVSI阳性的患者中,总生存率和无复发生存率均显著降低(P<0.05);COX回归结果显示,手术期别晚、非内膜样癌、LVSI影响子宫内膜癌患者的生存时间及结局(P<0.05)。结论LVSI与淋巴结转移密切相关,可作为预测淋巴结转移的重要因素;LVSI是子宫内膜癌不良预后的重要危险因素。
Objective To study the clinicopathological features and prognosis of endometrial carcinoma with lymphovascular space invasion (LVSI).Methods The data of 671 cases of endometrial carcinoma treated in Nanjing Drum Tower Hospital from January 2007 to December 2017 was retrospectively analyzed,including 120 cases in LVSI positive group and 551 cases in LVSI negative group.The clinicopathological information of patients was analyzed,and Kaplan-Meier curves were established.Univariate and multivariate analyses were performed.Results Compared with LVSI negative group,LVSI positive group was significantly higher in proporation of patients with menopause,late stage of operation and pathology,infiltration of deep muscle layer,poor tissue differentiation,lymph node metastasis,recurrence and death,the differences were statistically significant (P < 0.05).There was no statistical difference between the two groups in the proporation of patients with medical complications of hypertension,diabetes and uterine leiomyoma (P > 0.05).Multivariate analysis showed that cervical stroma involvement (OR = 0.342,95%CI: 0.134-0.873,P < 0.05) and LVSI (OR = 0.110,95%CI: 0.051-0.238,P < 0.01) were significantly correlated with lymph node metastasis.Survival rate analysis showed that both OS and RFS were significantly decreased in LVSI positive patients (P < 0.05).The results of COX regression showed that the survival time and outcome of endometrial carcinoma were affected by the late stage of operation and pathology,the nonendometrial carcinoma and LVSI (P < 0.05).Conclusion LVSI is closely related to lymph node metastasis and may be an important predictor of lymph node metastasis.LVSI is an important risk factor for poor prognosis of endometrial carcinoma.
作者
杨倩
周怀君
凌静娴
李荣
韩克
朱湘虹
汤晓秋
YANG Qian;ZHOU Huaijun;LING Jingxian;LI Rong;HAN Ke;ZHU Xianghong;TANG Xiaoqiu(Drum Tower Clinical Medical College of Nanjing Medical University,Jiangsu Province,Nanjing 210008,China;Department of Obstetrics and Gynecology,Nanjing Pukou Hospital,Jiangsu Province,Nanjing 210031,China;Department of Gynecology,Nanjing Drum Tower Hospital,Jiangsu Province,Nanjing 210008,China)
出处
《中国医药导报》
CAS
2019年第20期91-94,共4页
China Medical Herald
基金
江苏省自然科学基金项目(BK20151096)
江苏省南京市卫计委一般课题(YKK18231)
作者简介
通讯作者:周怀君.
