影响Ⅰ～Ⅱ期子宫内膜癌复发及患者生存预后的相关因素研究

摘要

Objective To explore the related factors affecting recurrence and prognosis of stage Ⅰ and Ⅱ endometrial carcinoma.Methods 120 cases of clinical stage Ⅰ,Ⅱendometrial carcinoma were retrospectively analyzed ,the correlation be-tween clinicopathological risk factors and the disease recurrence and prognosis were observed .The patients were divided into re-currence group and non-recurrence group ,and received multivariate regression analysis .Results There were 10(8.3%) cases of recurrence in 120 stage Ⅰ,Ⅱ endometrial adenocarcinoma.Age,length of cancer,infiltrating muscular layer,pathological type, pathologic stage ,ER positive ,PR negative and peritoneal cytology positive had correlation with recurrence of stage Ⅰ~Ⅱendom-etrial cancer.Multivariate analysis showed that older age ,longer muscular lesion,infiltrating over 1/2,pathological grade G3,ER positive and PR negative were the independent risk factors for recurrence of endometrial carcinoma (P<0.05).The survival rates of patients with endometrial cancer were reduced by ER positive and PR negative (P<0.05).Conclusion The recurrence of endometrial carcinoma has correlation with age ,histologic type,myometrial invasion,tumor grade,peritoneal cytology,tumor size, ER and PR status ,its survival rate are related with ER positive and PR negative .Regular follow-up of risk factors after treatment is essential for timely treatment of recurrence .%目的：探讨影响Ⅰ～Ⅱ期子宫内膜癌患者复发及生存预后的相关因素。方法采用回顾性研究方法共纳入120例Ⅰ～Ⅱ期子宫内膜癌的患者作为研究对象，随访观察患者的复发情况及生存预后情况，根据其是否复发分为复发组与未复发组，详细记录相关信息，筛选出影响复发的相关因素，并进行多因素回归分析。结果120例Ⅰ～Ⅱ期子宫内膜癌患者中，复发10例，复发率为8．3％。年龄、癌灶长径、浸润肌层、病理类型、病理分级、ER阳性、PR阴性及腹水细胞学阳性与Ⅰ～Ⅱ期子宫内膜癌复发存在相关性（P＜0．05）。年龄较大、癌灶长径较长、浸润肌层≥1／2、病理分级G3、ER阳性及PR阴性是影响Ⅰ～Ⅱ期子宫内膜癌复发的独立危险因素（P＜0．05）。 ER阳性与PR阴性均明显降低Ⅰ～Ⅱ期子宫内膜癌患者的生存率（P＜0．05）。结论Ⅰ～Ⅱ期子宫内膜癌复发受到年龄较大、癌灶较大、浸润肌层≥1／2、病理分级G3、ER阳性及PR阴性等影响，其生存率受ER阳性与PR阴性影响。在临床实际中对于具有上述危险因素的患者需要密切随访观察，以便及时发现复发病灶并进行治疗。