淋巴血管空间侵犯和细胞学在子宫内膜癌预后中的作用。

The Role of Lymphovascular Space Invasion and Cytology in the Prognosis of Endometrial Cancer.

机构信息

Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Gynecological Oncology, 03030 Afyonkarahisar, Turkey.

Afyonkarahisar Health Sciences University Hospital, Facutly of Medicine, Department of Obstetrics and Gynecology, 03030 Afyonkarahisar, Turkey.

出版信息

Discov Med. 2024 Feb;36(181):366-371. doi: 10.24976/Discov.Med.202436181.34.

DOI:10.24976/Discov.Med.202436181.34

PMID:38409841

Abstract

BACKGROUND

Lymphovascular space invasion (LVSI) and cytology are both independent and strong prognostic factors in endometrial cancer. This study aims to highlight the impact of LVSI and cytology positivity on prognosis, in addition to molecular classification.

METHODS

A retrospective review was conducted on the records of 223 patients with endometrial cancer diagnosed between January 2011 and January 2021. The inclusion criteria stipulated that the patients were diagnosed with endometrial cancer by endometrial biopsy and were operated in the clinic. The exclusion criteria included sarcoma in the postoperative pathology report results or synchronous tumor. Staging was performed according to the Fédération internationale de gynécologie et d'obstétrique (FIGO) 2009 criteria. Cytology (using 50 cc saline) was obtained upon entry into the peritoneal cavity. In 20 patients, saline was not used due to the presence of ascites in the abdomen. The Kaplan-Meier method was employed to evaluate overall survival and progression-free survival. Survival rates were compared in terms of cytology and LVSI.

RESULTS

After analyzing the postoperative pathology results, it was found that the mean tumor size was 4.03 ± 2.3 cm. The most common histological type was endometrioid carcinoma, with stage IA being the most common stage. Out of 223 patients with endometrial cancer, the overall survival rate was 82.4%, and the progression-free survival rate was 88.3%. For patients negative for LVSI, the progression-free survival rate was 93%, while for LVSI-positive patients, it was 77.3% ( < 0.001). Additionally, the progression-free survival rate for patients negative for cytology was 90.4%, whereas for cytology-positive patients, it was 77.1% ( < 0.05).

CONCLUSIONS

In our study, we observed that LVSI positivity and cytology positivity also reduced the overall survival rate. We aimed to highlight that, in addition to molecular classification, cytology positivity and LVSI positivity are still highly significant and independent factors in prognosis.

摘要

背景

淋巴血管空间侵犯（LVSI）和细胞学都是子宫内膜癌独立且强有力的预后因素。本研究旨在强调 LVSI 和细胞学阳性对预后的影响，以及分子分类。

方法

对 2011 年 1 月至 2021 年 1 月期间在我院就诊的 223 例子宫内膜癌患者的病历进行回顾性分析。纳入标准为经子宫内膜活检诊断为子宫内膜癌且在我院行手术治疗的患者；排除标准为术后病理报告结果为肉瘤或合并其他同步肿瘤的患者。分期根据国际妇产科联合会（FIGO）2009 标准进行。细胞学（采用 50cc 生理盐水）在进入腹腔时获取。20 例患者因腹部存在腹水而未使用生理盐水。采用 Kaplan-Meier 法评估总生存率和无进展生存率。比较了细胞学和 LVSI 与生存率的关系。

结果

术后病理结果分析发现，肿瘤平均直径为 4.03±2.3cm，最常见的组织学类型为子宫内膜样癌，最常见的分期为 IA 期。223 例子宫内膜癌患者中，总生存率为 82.4%，无进展生存率为 88.3%。LVSI 阴性患者的无进展生存率为 93%，而 LVSI 阳性患者为 77.3%（<0.001）。此外，细胞学阴性患者的无进展生存率为 90.4%，而细胞学阳性患者为 77.1%（<0.05）。