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子宫内膜癌的多变量独立预后因素:181例患者的临床病理研究:美因茨大学妇产科十年经验

Multivariate independent prognostic factors in endometrial carcinoma: a clinicopathologic study in 181 patients: 10 years experience at the Department of Obstetrics and Gynecology of the Mainz University.

作者信息

Steiner E, Eicher O, Sagemüller J, Schmidt M, Pilch H, Tanner B, Hengstler J G, Hofmann M, Knapstein P G

机构信息

Department of Obstetrics and Gynecology, Johannes Gutenberg-University, Mainz, Germany.

出版信息

Int J Gynecol Cancer. 2003 Mar-Apr;13(2):197-203. doi: 10.1046/j.1525-1438.2003.13021.x.

Abstract

The aim of this study was to evaluate the biologic outcome of endometrial carcinomas as compared to clinical and pathologic parameters and to identify multivariate independent prognostic factors. Charts were abstracted from patients with endometrial carcinoma from 1985 to 1995. Data on clinicopathologic variables, adjuvant treatment, site of recurrence, and survival were collected. chi2 test was used to test association between variables. Kaplan-Maier method was used for survival analysis and Cox proportional hazards model for multiple regression analysis. Univariate analysis revealed that FIGO stage, tumor grade, depth of myometrial invasion, biochemical analysis of progesterone receptor status, age, additional diabetes mellitus, lymph node metastasis, and type of tumor were significantly associated with the overall-survival. For disease-free interval, FIGO stage, tumor grade, depth of myometrial invasion, biochemical analysis of progesterone receptor status, lymph node metastasis, and type of tumor were also significantly associated. Multivariate analysis revealed that FIGO stage, tumor grading, tumor type, depth of myometrial invasion, and biochemically measured progesterone receptor status were associated significantly with overall survival. A significant correlation as independent prognostic factors were also seen for recurrence free interval for FIGO stage, tumor grade, and biochemical progesterone receptor status. In multivariate statistical analysis we identified FIGO stage, tumor type, tumor grade, biochemical analysis of progesterone receptor status, and depth of myometrial invasion as independent prognostic factors for overall survival, and FIGO stage, biochemical analysis of progesterone receptor status, and tumor grade as independent prognostic factors for recurrence-free interval.

摘要

本研究的目的是评估子宫内膜癌的生物学转归,并与临床和病理参数进行比较,以确定多变量独立预后因素。从1985年至1995年子宫内膜癌患者的病历中提取数据。收集了关于临床病理变量、辅助治疗、复发部位和生存情况的数据。采用卡方检验来检验变量之间的关联性。采用Kaplan - Meier方法进行生存分析,采用Cox比例风险模型进行多元回归分析。单因素分析显示,国际妇产科联盟(FIGO)分期、肿瘤分级、肌层浸润深度、孕激素受体状态的生化分析、年龄、是否合并糖尿病、淋巴结转移及肿瘤类型与总生存率显著相关。对于无病生存期,FIGO分期、肿瘤分级、肌层浸润深度、孕激素受体状态的生化分析、淋巴结转移及肿瘤类型也显著相关。多因素分析显示,FIGO分期、肿瘤分级、肿瘤类型、肌层浸润深度及生化测定的孕激素受体状态与总生存率显著相关。对于无复发生存期,FIGO分期、肿瘤分级及生化孕激素受体状态作为独立预后因素也存在显著相关性。在多变量统计分析中,我们确定FIGO分期、肿瘤类型、肿瘤分级、孕激素受体状态的生化分析及肌层浸润深度为总生存率的独立预后因素,而FIGO分期、孕激素受体状态的生化分析及肿瘤分级为无复发生存期的独立预后因素。

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