Deparment of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
Deparment of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
Eur J Surg Oncol. 2024 Apr;50(4):108260. doi: 10.1016/j.ejso.2024.108260. Epub 2024 Mar 8.
The aim of this study was to evaluate the risk factors for pelvic lymph node metastasis (LNM) and para-aortic LNM in non-endometrioid endometrial cancer (non-EEC).
A total of 283 patients with non-EEC hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2020 were included. Various characteristics were retrospectively analyzed in relation to LNM.
Univariable and multivariable logistic regression analysis revealed cervical stromal invasion (OR = 3.441, 95% CI = 1.558-7.6, p = 0.002), myometrial invasion ≥1/2 (OR = 2.661, 95% CI = 1.327-5.337, p < 0.006), lymphovascular space involvement (LVSI) (OR = 4.118, 95% CI = 1.919-8.837, p < 0.001), positive peritoneal cytology (OR = 2.962, 95% CI = 1.344-6.530, p = 0.007), CA125 (OR = 1.002, 95% CI = 1-1.004, p = 0.026) were the independent risk factors for pelvic LNM. And myometrial invasion ≥1/2 (OR = 5.881, 95% CI = 2.056-16.427, p = 0.001), LVSI (OR = 4.962, 95% CI = 1.933-12.740, p = 0.001), adnexal (OR = 5.921, 95% CI = 2.003-17.502, p = 0.001) were the independent risk factors for para-aortic LNM. With the increase of independent risk factors, the rates of LNM were increased significantly.
Cervical stromal invasion, myometrial invasion ≥1/2, LVSI, positive peritoneal cytology, and CA125 were risk factors for pelvic LNM. Myometrial invasion ≥1/2, LVSI and involvement of the adnexa were risk factors for para-aortic LNM which could provide a good basis to help predict which non-EEC patients are at higher risk for LNM.
本研究旨在评估非子宫内膜样癌（non-EEC）患者发生盆腔淋巴结转移（LNM）和腹主动脉旁淋巴结转移（para-aortic LNM）的风险因素。
回顾性分析 2012 年 1 月至 2020 年 12 月期间在郑州大学第一附属医院住院的 283 例非 EEC 患者的各项特征，与 LNM 相关的特征进行单变量和多变量逻辑回归分析。
单变量和多变量逻辑回归分析显示，宫颈间质浸润（OR=3.441，95%CI=1.558-7.6，p=0.002）、肌层浸润≥1/2（OR=2.661，95%CI=1.327-5.337，p<0.006）、脉管间隙浸润（LVSI）（OR=4.118，95%CI=1.919-8.837，p<0.001）、阳性腹腔细胞学检查（OR=2.962，95%CI=1.344-6.530，p=0.007）、CA125（OR=1.002，95%CI=1-1.004，p=0.026）是盆腔 LNM 的独立危险因素。肌层浸润≥1/2（OR=5.881，95%CI=2.056-16.427，p=0.001）、LVSI（OR=4.962，95%CI=1.933-12.740，p=0.001）、附件累及（OR=5.921，95%CI=2.003-17.502，p=0.001）是腹主动脉旁 LNM 的独立危险因素。随着独立危险因素的增加，LNM 发生率显著升高。
宫颈间质浸润、肌层浸润≥1/2、LVSI、阳性腹腔细胞学检查和 CA125 是盆腔 LNM 的危险因素。肌层浸润≥1/2、LVSI 和附件累及是腹主动脉旁 LNM 的危险因素，可为预测哪些非子宫内膜样癌患者有更高的 LNM 风险提供良好依据。
