Sakai Kensuke, Yamagami Wataru, Takahashi Fumiaki, Tokunaga Hideki, Yamamoto Eiko, Yokoyama Yoshihito, Yoshino Kiyoshi, Kawana Kei, Nagase Satoru
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
Department of Information Science, Iwate Medical University, Iwate, Japan.
J Gynecol Oncol. 2025 May;36(3):e41. doi: 10.3802/jgo.2025.36.e41. Epub 2024 Oct 25.
The prognostic value and clinical usage of peritoneal cytology in endometrial cancer are uncertain. This study aimed to determine whether positive cytology is associated with the prognosis for endometrial cancer.
A Japanese nationwide retrospective registry study was conducted between 2012 and 2019. Clinicopathological data were analyzed for patients who were registered in the Japan Society of Obstetrics and Gynecology (JSOG) gynecological tumor registry and underwent initial treatment for endometrial cancer.
In total, 83,027 patients who met the inclusion criteria were identified. Data on peritoneal cytology status and overall survival (OS) were available for 74,984 and 36,995 patients, respectively. Positive peritoneal cytology was found in 11,536 (15.4%) patients. A higher proportion of patients who had positive peritoneal cytology were related to advanced stages, high-grade histology, deep myometrial invasion, lymph node (LN) metastasis, and poor risk of recurrence. After controlling for age, stage, myometrial invasion, LN metastasis, distant metastasis, and risk of recurrence, positive peritoneal cytology was associated with poor prognosis (p<0.001). Multivariate Cox regression analysis revealed that clinicopathological factors (i.e., age, International Federation of Gynecology and Obstetrics stage, histological type, myometrial invasion, LN metastasis, distant metastasis, and peritoneal cytology), including positive peritoneal cytology, were also significant prognostic factors for OS.
Positive peritoneal cytology was a prognostic factor for endometrial cancer for the JSOG gynecological tumor registry.
子宫内膜癌中腹腔细胞学检查的预后价值及临床应用尚不确定。本研究旨在确定细胞学阳性是否与子宫内膜癌的预后相关。
在2012年至2019年间开展了一项日本全国性回顾性登记研究。对在日本妇产科学会（JSOG）妇科肿瘤登记处登记并接受子宫内膜癌初始治疗的患者的临床病理数据进行分析。
共确定了83027例符合纳入标准的患者。分别有74984例和36995例患者有腹腔细胞学检查状态及总生存期（OS）的数据。11536例（15.4%）患者腹腔细胞学检查呈阳性。腹腔细胞学检查阳性的患者中，较高比例与晚期、高组织学分级、子宫肌层深层浸润、淋巴结（LN）转移及复发风险高有关。在控制年龄、分期、子宫肌层浸润、LN转移、远处转移及复发风险后，腹腔细胞学检查阳性与预后不良相关（p<0.001）。多变量Cox回归分析显示，包括腹腔细胞学检查阳性在内的临床病理因素（即年龄、国际妇产科联盟分期、组织学类型、子宫肌层浸润、LN转移、远处转移及腹腔细胞学检查）也是OS的重要预后因素。
对于JSOG妇科肿瘤登记处的患者，腹腔细胞学检查阳性是子宫内膜癌的一个预后因素。
