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受精治疗后不孕女性早期子宫内膜癌和非典型子宫内膜增生复发相关因素分析

Analysis of Factors Associated With Recurrence of Early-Stage Endometrial Carcinoma and Atypical Endometrial Hyperplasia in Infertile Women After Fertilization Treatment.

作者信息

Guo Yaxing, Zong Xuan, Li Hongzhen, Qiao Jie

机构信息

Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

出版信息

Front Oncol. 2022 Jun 27;12:892995. doi: 10.3389/fonc.2022.892995. eCollection 2022.

DOI:10.3389/fonc.2022.892995
PMID:35832548
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9272564/
Abstract

PURPOSE

To explore the relationship between different artificial reproductive treatment (ART) strategies and tumor outcomes, by analyzing clinical data of patients with endometrial carcinoma (EC) and atypical endometrial hyperplasia (AEH).

METHODS

This retrospective study was performed in a tertiary hospital. Patients (n=131) with EC or AEH, who underwent fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment between June 2010 and June 2021, were divided into a recurrence group and a non-recurrence group. Clinical characteristics and tumor outcomes were assessed.

RESULTS

131 patients were followed up for 4-132 months; 33 patients had recurrence, the recurrence rate was 25.2%, 3-year recurrence-free survival (RFS) rate was 83.2 ± 3.4%, and the 5-year RFS rate was 72.9 ± 4.4%. Factors including the frequency of controlled ovarian stimulation (COS) and the total days of ovarian stimulation had no significant effect on the recurrence of tumor lesions (p=0.368 and 0.969, respectively). Histology type (HR: 4.94, 95%CI: 2.41-10.15, 0.001) and successful/un successful live birth (HR: 0.30, 95%CI: 0.14-0.65, =0.003) were independent factors of recurrence. Twenty-two of the 82 patients who received a single COS had recurrence. Different COS protocols, the total dose of gonadotropin (Gn), and the serum E level on the trigger day had no significant effect on recurrence (=0.326, 0.889 and 0.468, respectively).

CONCLUSIONS

The degree at which an endometrial lesion progresses into carcinoma is a key factor affecting the recurrence of EC/AEH in patients after IVF/ICSI treatment, and successful live birth is a protective factor for the recurrence of endometrial lesions. Different COS protocols and COS frequencies, as well as the dosage and duration of Gn used during IVF did not affect the recurrence of endometrial lesions.

摘要

目的

通过分析子宫内膜癌(EC)和非典型子宫内膜增生(AEH)患者的临床资料,探讨不同辅助生殖治疗(ART)策略与肿瘤预后之间的关系。

方法

本回顾性研究在一家三级医院进行。将2010年6月至2021年6月期间接受体外受精(IVF)/卵胞浆内单精子注射(ICSI)治疗的131例EC或AEH患者分为复发组和非复发组。评估临床特征和肿瘤预后。

结果

131例患者随访4 - 132个月;33例患者复发,复发率为25.2%,3年无复发生存(RFS)率为83.2±3.4%,5年RFS率为72.9±4.4%。控制性卵巢刺激(COS)频率和卵巢刺激总天数等因素对肿瘤病变复发无显著影响(p分别为0.368和0.969)。组织学类型(HR:4.94,95%CI:2.41 - 10.15,p = 0.001)和活产成功与否(HR:0.30,95%CI:0.14 - 0.65,p = 0.003)是复发的独立因素。82例接受单次COS的患者中有22例复发。不同的COS方案、促性腺激素(Gn)总剂量和扳机日血清E水平对复发无显著影响(p分别为0.326、0.889和0.468)。

结论

子宫内膜病变进展为癌的程度是影响IVF/ICSI治疗后患者EC/AEH复发的关键因素,活产成功是子宫内膜病变复发的保护因素。不同的COS方案和COS频率,以及IVF期间使用的Gn剂量和持续时间均不影响子宫内膜病变的复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b2c/9272564/2a0945e7f643/fonc-12-892995-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b2c/9272564/89cdb630df50/fonc-12-892995-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b2c/9272564/2a0945e7f643/fonc-12-892995-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b2c/9272564/89cdb630df50/fonc-12-892995-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b2c/9272564/2a0945e7f643/fonc-12-892995-g002.jpg

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