The novel criteria for predicting pelvic lymph node metastasis in endometrioid adenocarcinoma of endometrium
The novel criteria for predicting pelvic lymph node metastasis in endometrioid adenocarcinoma of endometrium
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DOI：
10.1016/j.ygyno.2012.01.051
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发表时间：
2012-05-01
影响因子：
4.7
通讯作者：
Cetin, Ahmet
中科院分区：
文献类型：
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作者：
Akbayir, Ozgur;Corbacioglu, Aytul;Cetin, Ahmet
Objective.目的探讨盆腔淋巴结转移的临床病理学危险因素，并评价这些因素在选择盆腔淋巴结清扫术患者中的临床有效性。方法回顾性分析2002年1月至2010年12月466例子宫内膜类腺癌行淋巴结清扫术患者的临床资料。所有患者均行盆腔淋巴结清扫术，192例（41.2%）患者同时行腹主动脉旁淋巴结清扫术。盆腔淋巴结的中位数为16个（范围：2-46），主动脉旁淋巴结的中位数为5个（范围：2-16）。盆腔淋巴结转移率为10.1%（47/466），腹主动脉旁淋巴结转移率为7.8%（15/192）。盆腔LNI在肿瘤分级较高、LVSI、深肌层浸润、腹膜细胞学阳性和宫颈受累的患者中更常见。Logistic回归分析显示LVSI、宫颈腺体浸润和宫颈间质浸润仍是LNI的独立危险因素。当LVSI和/或宫颈受累被认为是盆腔淋巴结转移的高风险时，NPV和特异性分别为96.3%和68.4%。LNI正确估计323例（69%），高估132例（28%），低估11例（2%）。LVSI、宫颈腺体和间质受累是盆腔LNI的独立危险因素。这些变量可以在术前或术中进行评估，准确率高，使用这些变量的模型可以成功地用于预测盆腔淋巴结转移。(C)2012 Elsevier Inc. All rights reserved.
Objective. To identify clinicopathological risk factors for pelvic lymph node metastasis, and to evaluate the clinical validity of these factors in selecting patients who need pelvic lymph node dissection.Methods. The data of 466 patients who had lymphadenectomy for endometrioid adenocarcinoma of the endometrium between January 2002 and December 2010 were reviewed retrospectively.Results. All patients underwent pelvic lymphadenectomy and 192 (41.2%) patients also underwent paraaortic lymphadenectomy. The median number of pelvic lymph node was 16 (range: 2-46) and of paraaortic lymph node was 5 (range: 2-16). 10.1% (47/466) of all patients had pelvic lymph node involvement and 7.8% (15/192) of the patients had paraaortic lymph node involvement (LNI). Pelvic LNI was significantly more common in the presence of higher grades of tumor, LVSI, deep myometrial invasion, positive peritoneal cytology and cervical involvement. The logistic regression analysis revealed that LVSI, cervical glandular invasion and cervical stromal invasion remained to be the independent risk factors for LNI. When the LVSI and/or cervical involvement were considered as high risk for pelvic lymph node metastasis, NPV and specificity were found to be 96.3% and 68.4%, respectively. LNI was correctly estimated in 323 women (69%), overestimated in 132 women (28%) and underestimated in 11 women (2%).Conclusion. LVSI, cervical glandular and stromal involvement were independent risk factors for pelvic LNI. These variables can be assessed pre- or intraoperatively with a high rate of accuracy, the model which uses these variables may be successfully used in the prediction of pelvic lymph node metastasis. (C) 2012 Elsevier Inc. All rights reserved.