目的 探讨子宫低级别子宫内膜样癌患者淋巴脉管间隙浸润(lymphovascular space invasion，LVSI)的影响因素。方法 回顾性分析2015年1月～2023年5月167例手术病理诊断低级别(G1、G2)子宫内膜样癌患者的临床资料。选择年龄、是否绝经、异常阴道出血时间、合并代谢综合征、CA125升高(≥35 U/ml)、子宫内膜厚度、宫腔占位、合并子宫腺肌症、国际妇产科联盟(International Federation of Gynecology and Obstetrics，FIGO)2009 分期 9 项指标进行单因素分析，对 P＜0。05 的因素进行二元logistic回归分析。结果 167例子宫低级别子宫内膜样癌患者中，LVSI24例(14。4％)。对单因素分析中P＜0。05的4项因素(异常阴道出血时间≥4个月、CA125升高、合并子宫腺肌症、分期Ⅱ期及以上)进行二元logistic回归分析，结果显示分期 Ⅱ 期及以上(OR=7。357，95％CI:2。140～25。288，P=0。002)，CA125 升高(OR=4。883，95％CI:1。612～14。794，P=0。005)为子宫低级别子宫内膜样癌LVSI的独立预后因素。结论 FIGO 2009分期Ⅱ期及以上、CA125 ≥35 U/ml与子宫低级别子宫内膜样癌患者LVSI有关，间接提示淋巴结转移风险，术前应高度关注，以便制定更为精准的手术方案。
Influence Factors of Lymphovascular Space Invasion in Low-grade Endometrioid Carcinoma of Uterus
Objective To investigate the influence factors of lymphovascular space invasion(LVSI)in patients with low-grade endometrioid carcinoma.Methods Clinical data of 167 patients with low-grade(G1,G2)endometrioid carcinoma of uterus diagnosed by surgical pathology from January 2015 to May 2023 were retrospectively analyzed.Univariate analysis of the following 9 indicators was performed:age,postmenopausal status,abnormal vaginal bleeding duration,combined with metabolic syndrome,increased CA125(≥ 35 U/ml),endometrial thickness,uterine occupation,combined with adenomyosis of uterus,stage of the International Federation of Gynecology and Obstetrics(FIGO)2009 standards.The binary logistic refression analysis was made on factors with P＜0.05.Results Among the 167 patients with low-grade endometrioid carcinoma of uterus,24 cases(14.4％)had LVSI.The binary logistic regression analysis was performed for 4 factors(abnormal vaginal bleeding duration ≥ 4 months,increased CA125,combined with adenomyosis of uterus,stage Ⅱ and above)with P＜0.05 in the univariate analysis,and the results showed stage Ⅱ and above(OR=7.357,95％CI:2.140-25.288,P=0.002)and increased CA125(OR=4.883,95％CI:1.612-14.794,P=0.005)were an independent prognostic factor for LVSI in low-grade endometrial carcinoma of uterus.Conclusion Stage Ⅱ(FIGO 2009)and above and CA125≥35 U/ml are associated with LVSI in patients with low-grade endometrioid carcinoma,indirectly suggesting the risk of lymph node metastasis,which should be paid close attention to before surgery in order to develop a more accurate surgical plan.
Endometrial carcinomaLow-gradeEndometrioid carcinomaLymphovascular space invasion
万方数据
维普
