肿瘤大小、浸润深度和组织学分级作为子宫内膜癌淋巴结转移的预后因素：一项 SEER 分析。
Tumor size, depth of invasion, and histologic grade as prognostic factors of lymph node involvement in endometrial cancer: a SEER analysis.
机构信息
Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Division of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
出版信息
Gynecol Oncol. 2014 May;133(2):216-20. doi: 10.1016/j.ygyno.2014.02.011. Epub 2014 Feb 16.
OBJECTIVES
The objective of this investigation was to evaluate the risk of nodal metastasis in patients with endometrial cancer, using the Mayo criteria, in a population-based analysis.
MATERIALS AND METHODS
Data from the SEER registry was reviewed for endometrial cancer cases diagnosed between 1988 and 2010. Patients were considered at low-risk for nodal metastasis if their tumors were histologic grade 1 or 2, myometrial invasion was less than 50%, and tumor size equal to or less than 2 cm. Patients not meeting these criteria were considered at high-risk for nodal involvement.
RESULTS
The final study group consisted of 19,329 women with surgically staged endometrial cancer. Of these, 1035 (5.3%) had lymph node involvement. Based on Mayo criteria, 4095 (21.1%) patients were found to be at low-risk and 15,234 (78.9%) at high-risk for nodal metastasis. Low-risk features were associated with a 1.4% risk for lymph node metastasis, compared to 6.4% in patients with high-risk features (p<0.001). When myometrial invasion was removed from the analysis, low-risk pathologic features were associated with a 2.4% risk of lymph node metastasis, compared to 10.4% in patients with high-risk features (p<0.001).
CONCLUSIONS
In a population-based analysis, women with low-risk endometrial cancer, as defined by the Mayo criteria, have a low rate of lymph node metastasis.
目的
本研究旨在通过基于人群的分析，用梅奥标准评估子宫内膜癌患者发生淋巴结转移的风险。
材料与方法
回顾 1988 年至 2010 年间诊断的子宫内膜癌病例的 SEER 登记处的数据。如果肿瘤组织学分级为 1 级或 2 级、肌层浸润小于 50%且肿瘤大小等于或小于 2cm，则认为患者的淋巴结转移风险较低。不符合这些标准的患者被认为具有淋巴结受累的高风险。
结果
最终的研究组包括 19329 例手术分期的子宫内膜癌患者。其中，1035 例（5.3%）有淋巴结受累。根据梅奥标准，4095 例（21.1%）患者被认为是低危，15234 例（78.9%）是高危。低危特征与 1.4%的淋巴结转移风险相关，而高危特征的患者淋巴结转移风险为 6.4%（p<0.001）。当从分析中去除肌层浸润时，低危病理特征与 2.4%的淋巴结转移风险相关，而高危特征的患者淋巴结转移风险为 10.4%（p<0.001）。
结论
在基于人群的分析中，用梅奥标准定义的低危子宫内膜癌女性淋巴结转移率较低。
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