子宫内膜癌淋巴结转移的高危因素临床分析

摘要

Objective To investigate the high-risk factors of endometrial carcinoma with lymph node metastasis(LNM)in order to provide the basis for individual therapy for the patients with endometrial carcinoma.Methods Clinical data of 105 patients with endometrial carcinoma in our hospital during a period from 2008 to 2013 were retrospectively analyzed.The high-risk factors for LNM were evaluated by the way of univariateχ2 statsistic analysis and binary logistic regression analysis.Results The LNMrate was 14.3%in 105 patients with en-dometrial carcinoma.12 cases (11.4%)had pelvic LNM,7cases (6.7%)had para-aortic LNMand 4cases (3.8%)had both.The analysis of Univariate χ2 analysis showed that pathological types,pathological grades,depth of myometrial invasion,vessel and cervical invasion were associated with LNM.Three independent factors as LNM were pathological grades,deep muscular invasion,vessel invasion.Conclusion The most common site of LNM was pelvic lymph nodes.endometrial carcinoma can metastasize to para-aortic lymph nodes directly and indirectly from pelvic lymph nodes.middle and poorly differentiated tumor,deep muscular invasion,vessel invasion were the independent high-risk fac-tors of LNM.%目的：探讨子宫内膜癌淋巴结转移的高危因素，为子宫内膜癌个体化治疗提供依据。方法对105例子宫内膜癌病例进行回顾性分析，采用χ2检验或多元logistic 回归分析淋巴结转移的高危因素。结果105例子宫内膜癌有15例淋巴结转移阳性，转移率为14．3％，其中12例（11．4％）盆腔淋巴结转移阳性，7例（6．7％）腹主动脉旁淋巴结转移阳性，4例（3．8％）盆腔及腹主动脉旁淋巴结转移均阳性。单因素分析显示，子宫内膜癌淋巴结转移与病理类型、病理分级、肌层浸润、宫颈侵润及脉管转移等因素相关。多因素logistic 回归分析显示，病理分级、深肌层浸润及脉管转移为淋巴结转移的独立高危因素。结论子宫内膜癌主要转移至盆腔淋巴结，直接或间接转移至腹主动脉旁淋巴结。中低分化、脉管转移、肌层浸润≥1/2可作为淋巴结转移的独立高危因素。