子宫内膜癌卵巢转移危险因素及保留卵巢的可行性探讨

目的:探讨子宫内膜癌卵巢转移的高危因素及术中保留卵巢的可行性。方法:回顾性分析1999年1月至2003年12月在四川大学华西第二医院首诊并行手术治疗的388例子宫内膜癌患者的临床病理资料。结果:26例(6.7%)发生卵巢转移,其中15例(57.7%)为隐性转移。多因素分析预测子宫内膜癌卵巢转移的独立危险因素,按危险强度排列为盆腔淋巴结转移、宫颈侵犯、肌层浸润深度、病理分级;卵巢大小、腹腔内转移是卵巢隐性转移的独立危险因素。结论:子宫内膜癌患者保留卵巢应审慎,应警惕隐性卵巢转移发生的可能。

Approach of the Ovarian Metastasis and Ovarian Preservation in Patients with Endometrial Carcinoma

Objective: To approach the risk factors for ovarian metastasis and the feasibility of ovarian preservation in patients with endometrial carcinoma.Methods: The clinicopathological features and outcomes of endometrial carcinoma patients who were diagnosed and treated from Jan 1999 to Dec 2003 in our hospital were retrospectively reviewed and analyzed.Results: Of the 388 cases reviewed, 26(6.7%) had ovarian metastasis,among which(57.7%) had recessive metastasis.Factors predictive of ovarian metastasis on multivariate analysis in these patients were ranked according to risk intensity: pelvic lymph node metastasis,cervical involvement,the depth of myometrial invasion,tumor grade.Size of the ovary and extrapelvic peritoneal metastasis were the independent risk factors of ovarian recessive metastasis on multivariate analysis.Conclusions: Deliberate attitude should be taken as to preserve the ovary or not.The potentiality of the ovarian recessive metastasis cannot be ignored.