Ⅰ型子宫内膜癌患者盆腔淋巴结转移危险因素分析

摘要

目的:探讨Ⅰ型子宫内膜癌患者盆腔淋巴结转移相关危险因素,为制定合理手术范围提供依据.方法:对136例Ⅰ型子宫内膜癌患者淋巴结转移的危险因素进行分析.单因素采用x2检验或Fisher确切概率法.多因素采用Logistic回归模型.结果:136例Ⅰ型子宫内膜癌患者盆腔淋巴结阳性率9.56％(13/136).单因素分析表明Ⅰ型子宫内膜癌的组织学分级、癌灶直径大小、肌层浸润深度、脉管浸润与淋巴结转移有关(P＜0.05);多因素Logistic回归模型分析显示组织低分化、肌层浸润深度≥1/2、癌灶直径≥2 cm、有脉管浸润是Ⅰ型子宫内膜癌盆腔淋巴结转移的独立危险因素(P＜0.05).结论:Ⅰ型子宫内膜癌患者盆腔淋巴结转移率低.组织低分化、肌层浸润深度≥1/2、癌灶直径≥2 cm、有脉管浸润的Ⅰ型子宫内膜癌患者更易发生盆腔淋巴结转移.%Objective:To investigate the high risk factors of pelvic lymph node metastasis in patients with type Ⅰ endometrial carcinoma in order to provide the basis for making reasonable operation scope.Methods:Risk factors of pelvic lymph node metastasis were analyzed in 136 cases of type Ⅰ endometrial carcinoma.Univariate analysis was performed with Chi square test or Fisher's exact probability method,and multivariate analysis was performed with a logistic regression mode.Results:The positive rate of pelvic lymph nodes in 136 patients with type Ⅰ endometrial carcinoma was 9.56％ (13/136).Univariate analysis showed that histological grade,size of lesion,depth of myometrial invasion and vascular invasion were related to lymph node metastasis(P ＜0.05);Multivariate Logistic analysis showed that low differentiation,deep muscular invasion,tumor diameter≥2 cm and LVSI were independent risk factors of pelvic lymph node metastasis in patients with type Ⅰ endometrial carcinoma(P ＜0.05).Conclusions:The rate of pelvic lymph node metastasis is low in type Ⅰ endometrial carcinoma.Patients with low differentiation,deep muscular invasion,tumor diameter≥2 cm and LVSI are more likely to occur pelvic lymph node metastasis in type Ⅰ endometrial carcinoma.