基于病例报道腹壁子宫内膜异位症透明细胞癌变相关预后因素分析
The Prognosis Factors Abdominal Wall Endometriosis Associated Clear Cell Carcinoma:A Pooled Analysis Based on Case Reports
虞梁 1袁琳 2孟黄洋 2杨雨琴 1赵明睿 1张林 2程文俊2
作者信息
- 1. 210029 南京医科大学第一临床医学院妇产科学系
- 2. 南京医科大学第一附属医院,江苏省人民医院妇科
- 折叠
摘要
目的:探讨影响腹壁子宫内膜异位症透明细胞癌变(abdominal wall endometriosis associated clear cell carcinoma,AWE-CCC)患者预后的相关因素.方法:系统检索 PubMed、EMBASE、MEDLINE、Google Scholar、Cochrane Library、万方、维普及中国知网数据库中包含AWE-CCC的相关文献,检索时间范围为1980年1月-2023年9月.使用Kaplan-Meier单因素生存分析及多因素Cox分析影响预后的因素,使用Apriori算法总结临床治疗规则.结果:纳入68例AWE-CCC患者.年龄≤46岁、病灶直径＞8 cm、病灶复发及复发间隔≤6个月是影响患者生存的不良预后因素(均P＜0.05).子宫切除对患者复发具有保护作用(HR=0.08,95％CI:0.01～0.81,P=0.03),且病灶切除联合子宫切除是强关联治疗规则.结论:在临床实践中,应重视患者年龄和病灶大小,初始治疗应包含病灶切除及子宫切除为基础的联合手术治疗以减少术后复发.
Abstract
Objective:To explore the prognostic factors associated with clear cell carcinoma of abdominal wall endometriosis(AWE-CCC).Methods:A systematic literature search for case reports on AWE-CCC was performed in PubMed,EMBASE,MEDLINE,Google Scholar,Cochrane Library,Wanfang,VIP and China National Knowledge Infrastructure(CNKI)from January 1980 to September 2023.Kaplan-Meier univariate survival analysis and multivariate Cox analysis were utilized to screen for factors affecting prognosis,and clinical treatment rules were summarized using the Apriori algorithm.Results:A total of 68 patients with AWE-CCC were included in this analysis.age ≤46 years old,lesion diameter＞8 cm,lesion recurrence and recurrence interval≤6 months might be poor prognostic factors for AWE-CCC(P＜0.05).Lesion excision plus hysterectomy were a strong therapeutic association rule and hysterectomy could offer recurrence protection(HR=0.08,95％CI:0.01-0.81,P=0.03).Conclusions:In clinical practice,patient's age and lesion size should be emphasized.The initial treatment should include lesion excision and hysterectomy-based combined surgical treatment to reduce postoperative recurrence.
关键词
腹壁/子宫内膜异位症/腺癌,透明细胞/预后/影响因素分析Key words
Abdominal wall/Endometriosis/Adenocarcinoma,clear cell/Prognosis/Root cause analysis引用本文复制引用
基金项目
江苏省"333工程"科研项目(BRA2019097)
出版年
2024
国家科技期刊平台
NSTL
万方数据