子宫内膜和卵巢双原发癌的预后影响因素分析

摘要

目的 探讨子宫内膜和卵巢双原发癌预后影响因素.方法 选取浙江省肿瘤医院1998年1月至2015年1月收治的子宫内膜和卵巢双原发癌78例为研究对象,记录患者的年龄、BMI指数、CA125、子宫内膜癌和卵巢癌病理分级和肿瘤分期、随访资料等,分析其预后影响因素.结果 子宫内膜和卵巢双原发癌中,CA125正常者25例(32.05％),CA125升高者53例(67.95％),且CA125正常者5年总生存率(94.3％)高于CA125升高者(73.2％),P＜0.05.子宫内膜癌组织学类型中子宫内膜样患者(82.8％ vs 67.6％)、子宫内膜癌和卵巢癌病理分级1+2级患者(88.2％ vs 58.2％;86.2％ vs 69.4％)、子宫卵巢共同分级其它级患者(82.9％ vs 67.7％)和卵巢癌肿瘤分期Ⅰ期患者(96.1％ vs 68.4％)的5年总生存率相对较高(均P＜0.05).多因素分析显示CA125升高和卵巢癌肿瘤分期级别高是双原发癌患者独立预后危险因素:HR (95％ CI)分别为1.142 (0.576 ～9.264)、0.311 (0.088 ～6.108),均P＜0.05.结论 CA125水平高和卵巢癌肿瘤分期级别高对判断双原发癌预后具有重要临床意义.%Objective To discuss the prognostic factors of the synchronous primary cancers of endometrium and ovary.Methods Totally 78 patients with endometrial and ovarian primary cancer admitted in Zhejiang Tumor Hospital from January 1998 to January 2015 were enrolled in this study.Age,BMI index,CA125,histological grade and tumor stage of ovarian cancer and uterine cancer as well as follow-up data were recorded.Univariate and multivariate analysis were used to evaluate the prognostic factors of patients with synchronous primary cancer of endometrium and ovary.Results Among the cases,CA125 was normal in 25 patients (32.05％) and increased in 53 patients (67.95％).Five-year overall survival rate of cases with normal CA125 was higher than that of cases with increased CA125 (94.3％ vs 73.2％,P ＜ 0.05).It was higher in cases of endometrioid histologic types (82.8％ vs 67.6％),cases of uterine and ovarian cancer grade 1 or 2 (88.2％ vs 58.2％;86.2％ vs 69.4％),cases of endometrial-ovarian co-grading in other grades (82.9％ vs 67.7％),cases of ovarian cancer stage Ⅰ of endometrium and ovary (96.1％ vs 68.4％) (all P ＜0.05).Multivariate analysis showed that increased level of CA125 and high tumor grade of ovarian cancer were independent prognostic factors of synchronous primary cancer of endometrium and ovarywith HR (95％ CI) value was 1.142 (0.576 ～9.264) and 0.311 (0.088 ～ 6.108),respectively (all P ＜ 0.05).Conclusion Increased level of CA125 and high grade of ovarian cancer have important clinical significance in predicting the prognosis of synchronous primary cancers of endometrium and ovary.