[1]尹希瑶,杜昕,张灿,等.早期低危型子宫内膜样癌复发危险因素分析[J].新乡医学院学报,2023,40(11):1078-1082.[doi:10.7683/xxyxyxb.2023.11.014]
　YIN Xiyao,DU Xin,ZHANG Can,et al.Analysis of the risk factors for recurrence of early low-risk endometrioid carcinoma[J].Journal of Xinxiang Medical University,2023,40(11):1078-1082.[doi:10.7683/xxyxyxb.2023.11.014]
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早期低危型子宫内膜样癌复发危险因素分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年11
页码:
1078-1082
栏目:
临床研究
出版日期:
2023-11-05

文章信息/Info

Title:
Analysis of the risk factors for recurrence of early low-risk endometrioid carcinoma
作者:
尹希瑶; 杜昕; 张灿; 赵昊斌; 秦海霞
（新乡医学院第一附属医院妇科，河南　卫辉　453100）
Author(s):
YIN Xiyao; DU Xin; ZHANG Can; ZHAO Haobin; QIN Haixia
(Department of Gynecology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
早期低危型子宫内膜样癌; 复发; 危险因素
Keywords:
early low-risk endometrial carcinoma; recurrence; risk factors
分类号:
R737.33
DOI:
10.7683/xxyxyxb.2023.11.014
文献标志码:
A
摘要:
目的　探讨早期低危型子宫内膜样癌复发的危险因素。
方法　选择2017年6月至2019年6月新乡医学院第一附属医院收治的103例早期低危型子宫内膜样癌患者为研究对象，根据是否复发将患者分为复发组（n=16）和非复发组（n=87）。通过查阅病历收集患者年龄、体质量指数（BMI）、是否合并高血压、是否合并糖尿病、术前125（CA125）和血小板计数、有无淋巴脉管间隙浸润（LVSI）以及术后雌激素受体（ER）、孕激素受体（PR）、p53、Ki67等临床资料。采用单因素分析和多因素logistic回归分析早期低危型子宫内膜样癌复发的危险因素，采用Kaplan-Meier曲线分析伴或不伴有复发独立危险因素患者的中位无复发生存期（RFS）。
结果　103例早期低危型子宫内膜样癌患者中，16例复发，复发率为15.53%。单因素分析结果显示，年龄、BMI、是否合并高血压或糖尿病、术前CA125水平、肿瘤病理分级、Ki67与早期低危型子宫内膜样癌复发无关（P>0.05），术前血小板计数、有无LVSI及ER、PR、p53表达情况与早期低危型子宫内膜样癌复发有关（P<0.05）。多因素logistic回归分析显示，有LVSI 、p53阳性表达、术前血小板计数升高是早期低危型子宫内膜样癌复发的独立危险因素（P<0.05）。复发组患者的中位RFS显著短于无复发组（P<0.05），有术前血小板计数升高患者的中位RFS显著短于无术前血小板计数升高患者（P<0.05），伴LVSI患者的中位RFS显著短于无LVSI患者（P<0.05），p53阳性表达患者的中位RFS显著短于p53阴性患者（P<0.05）。
结论　有LVSI、p53阳性、术前血小板计数升高可增加早期低危型子宫内膜样癌患者术后复发风险。
Abstract:
Objective　To investigate the risk factors for the recurrence of early low-risk endometrioid carcinoma.
Methods　A total of 103 patients with early low-risk endometrioid carcinoma admitted to the First Affiliated Hospital of Xinxiang Medical University from June 2017 to June 2019 were selected as research Subjects.According to the presence of recurrence,the patients were divided into recurrence group (n=16) and non-recurrence group (n=87).The clinical data including age,body mass index (BMI),hypertension,diabetes,preoperative carbohydrate antigen 125 (CA125) level and platelets count,lymph-vascular space invasion (LVSI),and expressions of postoperative estrogen receptor (ER),progesterone receptor (PR),p53 and Ki67 were collected by consulting medical records.The risk factor for recurrence of early low-risk endometrioid carcinoma was analyzed by using univariate analysis and multivariate logistic regression analysis,and the differences in median recurrence free survival (RFS) in patients with or without the independent risk factors were analyzed by using Kaplan-Meier curves.
Results　Among the 103 patients with early low-risk endometrial carcinoma,16 patients recurred,with a recurrence rate of 15.53%.Univariate analysis showed that age,BMI,presence or absence of hypertension and diabetes,preoperative CA125 level,tumor pathological grade,Ki67 expression of patients were not related to the recurrence of early low-risk endometrioid carcinoma (P>0.05);while the preoperative platelet count,LVSI,expressions of ER,PR and p53 of patients were related to the recurrence of early low-risk endometrioid carcinoma(P<0.05).Multivariate logistic regression analysis showed that the presence of LVSI,p53 positive expression,and preoperative elevated platelet count were the independent risk factors for early low-risk endometrial carcinoma recurrence (P<0.05).The median RFS of patients in the recurrent group was significantly shorter than that in the non-recurrent group (P<0.05),the median RFS of patients with increased preoperative platelet count was significantly shorter than that of patients without increased preoperative platelet count (P<0.05),the median RFS of patients with LVSI was significantly shorter than that of patients without LVSI (P<0.05),the median RFS of patients with p53 positive expression was significantly shorter than that of patients with p53 negative (P<0.05).
Conclusion　Patients with LVSI,p53 positive expression and elevated preoperative platelet levels can increase the risk of postoperative recurrence of early low-risk endometrial carcinoma.

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更新日期/Last Update: 2023-11-05