Hu C F, Li L L, Li L Y, Du Q, Zhang Y, Wang K P, Song Y
Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Medical Record Room, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2021 Sep 23;43(9):968-972. doi: 10.3760/cma.j.cn112152-20210304-00196.
To investigate the relationship of microcystic elongated fragmented (MELF) and clinicopathological features of patients with low grade endometrial endometrioid carcinoma, and to analyze its impact on prognosis. The clinical pathological data of 512 cases with low grade endometrial endometrioid adenocarcinoma were collected. The MELF invasive pattern in all of the sections were reappraised. The correlations between MELF pattern and clinicopathological features were analyzed by chi-square test, and the independent risk factor of lymph node metastasis were evaluated by Logistic multivariate regression analysis. Survival curves was drawn by Kaplan-Meier method, and Log-rank test was used to compare progression free survival (PFS) between patients with or without MELF pattern. Disease progression-related multivariate analysis was carried out by Cox proportional hazards model. MELF pattern was observed in 12.9% (66/512) low grade endometrioid adenocarcinoma. It was significantly associated with cervical stroma invasion, more than half of the depth of myometrial invasion, lymph node metastasis and vessel invasion (<0.05). In addition, MELF pattern was an independent risk factor for lymph node metastasis (<0.05). The 5-year PFS of patients with and without MELF pattern were 95.0% and 96.0% respectively (>0.05). The patients with MELF pattern are more likely accompany with cervical stroma and deeper myometrium invasion, vessel invasion, and lymph node metastasis, and it is an independent risk factor of lymph node metastasis. However, MELF pattern has no significant impact on prognosis of patients with endometrioid carcinoma.
探讨微囊型拉长破碎状（MELF）与低级别子宫内膜样腺癌患者临床病理特征的关系，并分析其对预后的影响。收集512例低级别子宫内膜样腺癌患者的临床病理资料，重新评估所有切片中的MELF浸润模式。采用卡方检验分析MELF模式与临床病理特征之间的相关性，通过Logistic多因素回归分析评估淋巴结转移的独立危险因素。采用Kaplan-Meier法绘制生存曲线，用Log-rank检验比较有无MELF模式患者的无进展生存期（PFS）。采用Cox比例风险模型进行疾病进展相关的多因素分析。在512例低级别子宫内膜样腺癌中，12.9%（66/512）观察到MELF模式。它与宫颈间质浸润、肌层浸润深度超过一半、淋巴结转移和血管浸润显著相关（<0.05）。此外，MELF模式是淋巴结转移的独立危险因素（<0.05）。有和无MELF模式患者的5年PFS分别为95.0%和96.0%（>0.05）。具有MELF模式的患者更易伴有宫颈间质和更深的肌层浸润、血管浸润及淋巴结转移，且是淋巴结转移的独立危险因素。然而，MELF模式对子宫内膜样腺癌患者的预后无显著影响。
