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息肉样生长模式与子宫内膜样型子宫内膜腺癌淋巴结受累的相关性。

The association of polypoid growth pattern with lymph node involvement in endometrioid type endometrial adenocarcinoma.

作者信息

Bezircioglu Incim, Yetimalar Mehmet H, Kilic Derya, Yigit Seyran

机构信息

Department of Obstetrics and Gynecology, Izmir Economy University Hospital, Izmir, Turkey.

Department of Obstetrics and Gynecology, Izmir Gozde Hospital, Izmir, Turkey.

出版信息

Indian J Cancer. 2023 Apr-Jun;60(2):230-236. doi: 10.4103/ijc.IJC_1044_20.

DOI:10.4103/ijc.IJC_1044_20
PMID:37530246
Abstract

BACKGROUND

Tumor size is an independent predictor of lymph node metastasis and survival in the endometrioid type endometrial adenocarcinoma (EC). However, some of the ECs tend to grow towards the cavity in the polypoid pattern, which can reach very large sizes. In this study, we aimed to analyze the association of growing in the polypoid pattern of the tumor with the proportion of lymph node metastasis and extrauterine tumor spread.

METHODS

Four hundred seven patients were analyzed retrospectively. The effect of tumor size, tumor growing pattern, myometrial invasion, grade, and lymphovascular space invasion on the lymph node metastasis and extrauterine tumor spread were investigated. Statistical analysis consisted of unpaired t-tests for parametric data and Mann Whitney-U test for non-parametric data, whereas the Chi-square test for categorical variables. Logistic Regression, Cox Regression and multivariate analysis were used to estimate the risk predictors.

RESULTS

No association was found between the growing in polypoid pattern and lymph node metastasis (P > 0.05). In the analysis of endometrioid type EC patients who had myometrial invasion less than ½ as a subgroup, no association was found between the growing pattern and lymph node metastasis and extrauterine disease. Tumor size was found to be a statistically significant predictor of lymph node metastasis and extrauterine disease (P < 0.05).

CONCLUSIONS

Lymphovascular space invasion, grade, and myometrial invasion are associated with a higher proportion of lymph node metastasis. The polypoid growth pattern of the tumor does not correlate with any histopathological parameters.

摘要

背景

肿瘤大小是子宫内膜样型子宫内膜腺癌(EC)中淋巴结转移和生存的独立预测指标。然而,部分EC倾向于以息肉样模式向宫腔内生长,其大小可达很大。在本研究中,我们旨在分析肿瘤的息肉样生长模式与淋巴结转移比例及子宫外肿瘤播散之间的关联。

方法

对407例患者进行回顾性分析。研究肿瘤大小、肿瘤生长模式、肌层浸润、分级及淋巴管间隙浸润对淋巴结转移和子宫外肿瘤播散的影响。统计分析包括对参数数据采用非配对t检验,对非参数数据采用曼-惠特尼U检验,对分类变量采用卡方检验。采用逻辑回归、Cox回归和多变量分析来评估风险预测因素。

结果

未发现息肉样生长模式与淋巴结转移之间存在关联(P>0.05)。在将肌层浸润小于1/2的子宫内膜样型EC患者作为一个亚组进行分析时,未发现生长模式与淋巴结转移及子宫外疾病之间存在关联。发现肿瘤大小是淋巴结转移和子宫外疾病的一个具有统计学意义的预测指标(P<0.05)。

结论

淋巴管间隙浸润、分级及肌层浸润与较高比例的淋巴结转移相关。肿瘤的息肉样生长模式与任何组织病理学参数均无相关性。

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