Kinjyo Yoshino, Kudaka Wataru, Ooyama Takuma, Inamine Morihiko, Nagai Yutaka, Aoki Yoichi
Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan.
Acta Obstet Gynecol Scand. 2015 Apr;94(4):430-4. doi: 10.1111/aogs.12588. Epub 2015 Mar 1.
To clarify the frequency and risk factors of ovarian metastasis in women with endometrial cancer of endometrioid histology.
Retrospective observational study.
University of the Ryukyus Japan 1990-2011.
Eighty-eight women ≤ 45 years of age with endometrial cancer of only endometrioid histology.
Clinicopathological factors from the medical records were used. Fisher's exact test and logistic regression analysis were used to analyze predictive factors for ovarian metastasis.
Risk factors of ovarian malignancy.
All women underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and lymph node dissection. The median age was 39 years, and FIGO stage distributions were: stage I, 63 (71.6%) women; stage II, 14 (15.9%) women; and stage III, 11 (12.5%) women. Pathologically, ovarian metastasis was observed in four (4.5%) women. Only lymph node metastasis was a significant predictive factor for ovarian metastasis (p = 0.0038), and deep myometrial invasion was the only significant factor (p = 0.0085) for the prediction of lymph node metastasis. No ovarian malignancy was found in 72 women with invasion ≤ 50% myometrial depth and no enlargement of the ovaries. We observed ovarian metastasis in two (14.3%) of 14 women with deep myometrial invasion without ovarian tumor.
Ovarian preservation surgery might be considered in endometrial cancer of endometrioid histology with ≤ 50% myometrial depth invasion with no ovarian mass after taking into account family history.
明确子宫内膜样组织学类型的子宫内膜癌女性患者卵巢转移的发生率及危险因素。
回顾性观察研究。
日本琉球大学，1990年至2011年。
88名年龄≤45岁、仅为子宫内膜样组织学类型的子宫内膜癌女性患者。
使用病历中的临床病理因素。采用Fisher精确检验和逻辑回归分析来分析卵巢转移的预测因素。
卵巢恶性肿瘤的危险因素。
所有女性均接受了全腹子宫切除术、双侧输卵管卵巢切除术及淋巴结清扫术。中位年龄为39岁，国际妇产科联盟（FIGO）分期分布如下：I期，63名（71.6%）女性；II期，14名（15.9%）女性；III期，11名（12.5%）女性。病理检查发现，4名（4.5%）女性存在卵巢转移。仅淋巴结转移是卵巢转移的显著预测因素（p = 0.0038），而肌层深部浸润是预测淋巴结转移的唯一显著因素（p = 0.0085）。在72名肌层浸润≤50%且卵巢未增大的女性中未发现卵巢恶性肿瘤。在14名肌层深部浸润但无卵巢肿瘤的女性中，我们观察到2名（14.3%）发生了卵巢转移。
对于子宫内膜样组织学类型、肌层浸润深度≤50%且无卵巢肿块的子宫内膜癌女性患者，在考虑家族史后，可考虑保留卵巢手术。
