Clinicopathological Risk Factors for Pelvic Lymph Node Metastasis in Clinical Early-Stage Endometrioid Endometrial Adenocarcinoma
Clinicopathological Risk Factors for Pelvic Lymph Node Metastasis in Clinical Early-Stage Endometrioid Endometrial Adenocarcinoma
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临床早期子宫内膜样腺癌盆腔淋巴结转移的临床病理学危险因素
DOI：
10.1097/igc.0b013e318269f68e
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发表时间：
2012-10
影响因子：
4.8
通讯作者：
Feng Weiwei
中科院分区：
文献类型：
--
作者：
Zhang Chuyao;Wang Chao;Feng Weiwei
目的 明确盆腔淋巴结（PLN）转移的临床病理危险因素，评价这些因素对临床早期子宫内膜样子宫内膜腺癌（EEA）淋巴结清扫术的预测意义。方法 回顾性回顾1989年至2006年在复旦大学附属妇产科医院行子宫切除加双侧输卵管卵巢切除加盆腔和（或）主动脉旁淋巴结切除术的临床早期EEA（肿瘤局限于子宫，术前或术中诊断）患者621例。分析PLN转移危险因素的预测价值。结果PLN阳性转移率为3.9%。 PLN转移阳性组的5年疾病相关死亡率为25%，而阴性组为0.8%。肿瘤级别较高、肌层深部浸润、宫颈间质受累、淋巴管间隙受累（LVSI）的患者PLN阳性转移率较高。高龄（≥60岁）、3级、癌症深肌层浸润、宫颈间质受累和LVSI预测PLN转移的敏感性和特异性分别为25.0%、41.7%、70.8%、20.8%和41.7%；分别为 79.1%、88.4%、85.6%、95.6% 和 94.5%。多因素分析显示深部肌层浸润和LVSI是淋巴结转移的独立危险因素。结合这2个因素作为诊断标准，阴性预测值和特异性分别为97.3%和89.1%。结论 临床早期EEA伴PLN转移的患者虽然转移率较低，但预后较差。深肌层浸润和 LVSI 组合是 PLN 转移的优越预测标准。术前或术中准确评估这些因素将有利于预测PLN转移并指导手术。
Objective To identify the clinicopathological risk factors for pelvic lymph node (PLN) metastasis and to evaluate the predictive significance of these factors for lymphadenectomy in clinical early-stage endometrioid endometrial adenocarcinoma (EEA). Methods Six hundred and twenty-one patients with clinical early-stage EEA (tumor confined to uterus, diagnosed preoperatively or intraoperatively) who underwent hysterectomy plus bilateral salpingo-oophorectomy plus pelvic and/or para-aortic lymphadenectomy between 1989 and 2006 in the Obstetrics and Gynecology Hospital of Fudan University were retrieved. The predictive value of the risk factors for PLN metastasis was analyzed. Results The positive PLN metastasis rate was 3.9%. The 5-year disease-related mortality rate in the positive PLN metastasis group was 25%, whereas the rate in the negative group was 0.8%. The positive PLN metastasis rates were higher in patients with higher-grade tumors, deep myometrial invasion, cervical stromal involvement, and lymphovascular space involvement (LVSI). The sensitivity and specificity of old age (≥60 years), grade 3, cancer deep myometrial invasion, cervical stromal involvement, and LVSI in predicting the PLN metastasis were 25.0%, 41.7%, 70.8%, 20.8%, and 41.7%; and 79.1%, 88.4%, 85.6%, 95.6%, and 94.5%, respectively. The multivariate analysis revealed that the deep myometrial invasion and LVSI were independent risk factors for lymph node metastasis. Combined with these 2 factors as the diagnostic criteria, the negative predictive value and specificity were 97.3% and 89.1%, respectively. Conclusion The patients with clinical early-stage EEA with PLN metastasis showed worse prognoses, although the metastasis rate was low. The deep myometrial invasion and LVSI combination were superior predictive criteria for the PLN metastasis. An accurate evaluation of these factors, both preoperatively or intraoperatively, will be beneficial to predict PLN metastasis and guide the operation.
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影响因子：
2.4
作者：
Xi Tang;K. Tanemura;W. Ye;Kazuo Ohml;R. Tsunematsu;Takuro Yamada;Noriyuki Katsumatal;T. Sonoda
通讯作者：
Xi Tang;K. Tanemura;W. Ye;Kazuo Ohml;R. Tsunematsu;Takuro Yamada;Noriyuki Katsumatal;T. Sonoda
影响因子：
3.7
作者：
Jong‐Hyuck Yoon;S. Yoo;W. Kim;Suk-Joon Chang;K. Chang;H. Ryu
通讯作者：
Jong‐Hyuck Yoon;S. Yoo;W. Kim;Suk-Joon Chang;K. Chang;H. Ryu
DOI：
10.1016/j.ejso.2006.02.008
发表时间：
2006-05
期刊：
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
影响因子：
--
作者：
Laura Zuurendonk;R. Smit;B. Mol;H. Feijen;J. D. Graaff;D. Sykora;K. Winter;A. V. Wurff;M. Snijders;R. Kruitwagen
通讯作者：
Laura Zuurendonk;R. Smit;B. Mol;H. Feijen;J. D. Graaff;D. Sykora;K. Winter;A. V. Wurff;M. Snijders;R. Kruitwagen
影响因子：
4.7
作者：
Huang, Marilyn;Chadha, Manjeet;Holcomb, Kevin
通讯作者：
Holcomb, Kevin
影响因子：
10.3
作者：
Panici, Pierluigi Benedetti;Basile, Stefano;Mangioni, Costantino
通讯作者：
Mangioni, Costantino