淋巴结清扫术对子宫内膜样腺癌预后的影响

目的 探讨淋巴结清扫术与子宫内膜样腺癌预后的关系.方法 收集诊断明确、接受系统手术治疗且有术后随访资料的子宫内膜样腺癌患者86例作为研究对象,其中58例行淋巴结清扫术（清扫组）,28例未行淋巴结清扫术（未清扫组）.对相关病理特征与淋巴结清扫状态的关系进行单因素分析,并通过生存分析了解淋巴结清扫术与子宫内膜样腺癌患者预后的关系.结果 清扫组和未清扫组3年疾病特异生存率（DSS）分别为82.1％和61.8％,两组比较差异有统计学意义（P=0.006）.清扫组和未清扫组FIGO Ⅰ A期患者3年DSS分别为93.8％和95.7％,两组比较差异无统计学意义（P=0.704）；FIGO Ⅰ B～Ⅳ期患者3年DSS分别为49.1％和35.4％,两组比较差异有统计学意义（P=0.044）.相关性分析结果显示,FIGO分期晚期（≥ⅠB期）、高组织学分级（G2-3级）是独立的3年DSS预后不良因素；而淋巴结清扫术则是独立的3年DSS预后良好因素.结论 淋巴结清扫术可改善FIGO Ⅰ B～Ⅳ期子宫内膜样腺癌患者的预后,具有治疗意义.

The effects of lymphadenectomy on the prognosis of endometrioid adenocarcinoma

Objective To investigate the relationship between lymphadenectomy and the prognosis of endometrioid adenocarcinoma.Methods Eighty-six cases of endometrioid adenocarcinoma patients who got a clear diagnosis and accepted system surgical treatment and had complete follow-up data were collected in this study.Fifty-eight cases routined lymphadenectomy （lymphadectomy group）,and 28 cases didn＆#39;t routine lymphadenectomy （without lymphadectomy group）.The relationship between related pathological features and lympha node dissection state were evaluated by univariate analysis,and through survival analysis to understand the relationship between lymphadenectomy and the prognosis of endometrioid adenocarcinoma.Results The 3-years disease-specific survival rate （DSS） in lymphadectomy group and without lymphadectomy group were 82.1% and 61.8%,which reached statistical significance （P =0.006）.The 3-year DSS of FIGO Ⅰ A stage in lymphadectomy group and without lymphadectomy group were 93.8% and 95.7% （P=0.704）,the 3-year DSS of FIGO Ⅰ B-Ⅳ stage in lymphadectomy group and without lymphadectomy group were 49.1% and 35.4%,which reached statistical significance （P =0.044）.Correlation analysis results showed that FIGO stage late （≥ Ⅰ B stage）,higher tumor grade （G2-3 grade） were independent poor prognosis factors of 3-year DSS,and lymphadenectomy was an independent good prognosis factor.Conclusion Lymphadectomy can improve the prognosis of endometrioid adenocarcinoma patients who are FIGO Ⅰ B-Ⅳ stage,has therapeutic significance.