子宫内膜癌淋巴取样术的临床意义

目的：探讨子宫内膜癌盆腔及腹主动脉旁淋巴取样的临床意义。方法：分析1995年1月～2002年12月本院手术治疗的311例子宫内膜癌患者,其中,197例行淋巴取样或淋巴清扫。手术方式根椐手术切除淋巴结情况分为二组。1）取样组,筋膜外全子宫双附件切除/次广泛子宫切除术＋盆腔/腹主动脉旁淋巴结取样术114例;2）清扫组,次广泛/广泛子宫切除术＋盆腔淋巴结清扫/腹主动脉旁淋巴结切除术83例。结果：取样组切除淋巴结中位组数5组,中位切除淋巴结15枚,淋巴结转移8例。清扫组切除淋巴结中位组数8组,中位切除淋巴结27枚,淋巴结转移6例。5年生存率分别为90.2%和90.9%。结论：子宫内膜癌淋巴取样术可准确了解淋巴结转移情况,适宜手术分期,并不影响生存率,是避免过度治疗的方法。

Clinical Significance of Lymph Node Sampling in Endometrial Carcinoma

Objective: To study the clinical significance of pelvic and para-aortic lymph node sampling in endometrial carcinoma. Methods: Data of 311 patients who received surgical treatment in our hospital during the period from January 1995 to December 2002 were analyzed. Among the patients 197 underwent lymph node sampling or lymphadenectomy. The patients were divided into 2 groups based on the surgical method used for the lymph node dissection. The sampling group included 114 patients who underwent an extrafascial hysterectomy or modified radical hysterectomy plus pelvic or para-aortic lymph node sampling of abdominal aorta, and the dissection group included 83 patients who received radical or modified radical hysterectomy plus systemic pelvic lymph node clearance or para-aortic lymph node dissection of the abdominal aorta. Results: The median number of lymph nodes removed was 5 in the sampling group and the median number of lymph nodes sampled was 15 per case. Lymph node metastasis was found in 8 cases. In the dissection group, the median number of lymph nodes removed was 8 and the median number of lymph nodes sampled was 27 per case. Lymph node metastasis was found in 6 cases. The 5-year survival rate was 90.2% in the sampling group and 90.9% in the dissection group. Conclusion: Lymph node sampling is a good way to precisely locate endometrial cancer lymphatic metastasis and this method is suitable for surgical staging without causing extensive surgical damage or affecting the survival rate.