86例子宫内膜样腺癌附件转移患者的临床病理特征分析

摘要

Objective:To investigate the clinicopathological features of endometrial endometrioid adenocarcinoma(EEA)with adnexal involvement.Methods The clinicopathological data of 86 EEA patients who underwent surgical treatment at our center from January 2000 to December 2015 were analyzed retrospectively.The clinicopathological features were compared between patients with occult adnexal involvement and those with gross adnexal involvement.Results A total of 86 EEA patients with adnexal involvement(mean age:58.1 years)were included in this study,accounting for 5.4%(86/1592)of the EEA patients during the same period.Among these 86 patients,there were 13 premenopausal patients(15.1%)including 2 premenopausal patients aged under 40 years.Gross adnexal involvement was found in 47 patients(54.7%),while occult adnexal involvement was found in 39 patients(45.3%)in pathology evaluation.Ovarian metastasis was found in 34 patients(39.5%),followed by both ovarian and tubal metastasis in 19 patients(22.1%)and tubal metastasis in 33 patients(38.4%).The expressionss of estrogen receptor(χ2=8.086,P=0.042)and progesterone receptor(PR)(χ2=9.149,P=0.026)were significantly different between gross adnexal involvement group and occult adnexal involvement group,whereas no significant difference was found in other clinicopathological features(all P>0.05).The non-conditional Logistic regression analysis showed that,compared with PR no-expression group,the rate of occult microscopic adnexal involvement in PR low-expression group was 6.375 times of that of the gross adnexal involvement(P=0.005,95%CI:1.768-22.976),and the rate of occult microscopic adnexal involvement in the PR high-expression group was 3.719 times of that of gross adnexal involvement(P=0.048,95%CI:1.009-13.702). Conclusion PR expression level is remarkably lower in EEA patients with gross adnexal involvement than those with occult adenxal involvement.%目的 分析86例子宫内膜样腺癌附件转移患者的临床病理特征.方法 回顾性总结2000年1月至2015年12月在中国医学科学院肿瘤医院妇科接受手术治疗的86例子宫内膜样腺癌附件转移患者的临床病理资料,比较大体转移和隐匿性转移患者间的临床病理特征.结果 86例患者占同期子宫内膜样腺癌患者总人数的5.4%(86/1592),平均年龄58.1岁,其中,未绝经13例(15.1%),40岁以下2例(2.3%);手术探查发现附件存在大体转移47例(54.7%),术后病理证实隐匿性转移39例(45.3%);卵巢转移34例(39.5%),输卵管和卵巢转移19例(22.1%),单纯输卵管转移33例(38.4%).大体转移组和隐匿性转移组患者的雌激素受体(χ2=8.086,P=0.042)和孕激素受体(PR)(χ2=9.149,P=0.026)表达水平差异有统计学意义;其余临床病理特征两组间差异均无统计学意义(P均>0.05).非条件Logistic回归分析结果显示,与无表达组相比,PR低表达组的隐匿性转移发生率是大体转移的6.375倍(P=0.005,95%CI:1.768~22.976),PR高表达组的隐匿性转移发生率是大体转移的3.719倍(P=0.048,95%CI:1.009~13.702).结论 子宫内膜样腺癌附件大体转移患者的PR表达水平明显低于隐匿性转移患者.