Kamura T, Yahata H, Shigematsu T, Ogawa S, Amada S, Kaku T, Nakano H
Faculty of Medicine, Kyushu University, Fukuoka, 812-8582, Japan.
Gynecol Oncol. 1999 Mar;72(3):387-91. doi: 10.1006/gyno.1998.5288.
To determine the possibility of individualizing the pelvic lymph node dissection in patients with endometrial cancer, the relationship between pelvic lymph node (PLN) metastasis and various prognostic factors was retrospectively investigated.
From 1979 to 1994, 175 patients with endometrial carcinoma were treated with either total or radical hysterectomy combined with a PLN dissection as initial therapy. The prognostic factors examined included clinical stage, patient age, histological grade, the microscopic degree of myometrial invasion (DMI), cervical invasion, adnexal metastasis, and macroscopic tumor diameter (TD).
Of the 175 patients undergoing PLN dissection, 24 (14%) had PLN metastasis. An endometrial cancer with PLN metastasis had a significantly longer diameter than those without PLN metastasis. The frequency of PLN metastasis increased along with increases in tumor diameter. A logistic regression analysis revealed DMI and TD to be independently correlated with PLN metastasis. The formula based on the coefficients of TD and DMI obtained from the analysis also showed a good correlation, which allowed us to estimate the probability of patients having PLN metastasis.
DMI and TD could accurately estimate the status of PLN in endometrial carcinoma patients.
为了确定子宫内膜癌患者盆腔淋巴结清扫个体化的可能性，回顾性研究盆腔淋巴结（PLN）转移与各种预后因素之间的关系。
1979年至1994年，175例子宫内膜癌患者接受了全子宫切除术或根治性子宫切除术联合PLN清扫作为初始治疗。检查的预后因素包括临床分期、患者年龄、组织学分级、肌层浸润微观程度（DMI）、宫颈浸润、附件转移和肿瘤宏观直径（TD）。
在175例行PLN清扫的患者中，24例（14%）有PLN转移。有PLN转移的子宫内膜癌直径明显长于无PLN转移的患者。PLN转移频率随肿瘤直径增加而增加。逻辑回归分析显示DMI和TD与PLN转移独立相关。根据分析得到的TD和DMI系数得出的公式也显示出良好的相关性，这使我们能够估计患者发生PLN转移的概率。
DMI和TD可以准确估计子宫内膜癌患者的PLN状态。
