【摘要】 目的分析子宫内膜癌患者卵巢转移病理特点及保留卵巢可行性。方法选取2015年10月至2016年10月于河南科技大学第一附属医院接受治疗的子宫内膜癌患者206例,患者均行手术治疗,依据国际妇产科联盟2009年修订子宫内膜癌的手术分期标准,分析患者的年龄、CA125、病理类型、卵巢转移等情况;单因素及多因素分析子宫内膜癌卵巢转移的影响因素。结果年龄大于45岁的患者有167例,卵巢转移发生率为7.78%(13/167);年龄小于等于45岁的患者有39例,卵巢转移发生率为7.69%(3/39)。属于特殊病理类型24例,卵巢转移发生率为16.67%(4/24);子宫内膜样腺癌患者182例,卵巢转移发生率为6.04%(11/182)。无宫颈受累患者171例,卵巢转移发生率为5.26%(9/171);有宫颈受累患者35例,卵巢转移发生率为17.14%(6/35)。在患者进行手术前临床Ⅳ期的有5例,发生卵巢转移的有3例;临床Ⅲ期的有13例,发生卵巢转移的有6例;临床Ⅱ期的有40例,发生卵巢转移的有3例;临床Ⅰ期的有128例,发生卵巢转移的有3例。其中病理类型、宫颈受累、临床分期与患者发生卵巢转移差异有统计学意义(P<0.05);患者CA125呈阳性及较低分化程度是发生卵巢转移的独立危险因素(P<0.05)。结论患者病型、宫旁转移、肿瘤分级、盆腔淋巴结转移及肌层侵蚀程度是子宫内膜癌症发生卵巢转移主要影响因素,患者术前需严格评估确定是否保留卵巢。更多还原

【Abstract】 Objective To study the pathological characteristics of ovarian metastasis in patients with endometrial carcinomaand to study the feasibility of ovarian preservation. Methods 206 cases from October 2015 to October 2016 in our hospitalwere selected. Patients underwent surgical treatment,according to the International Federation of gynecology and obstetrics2009 revision surgery of endometrial cancer staging criteria,analysis of the patient’s age,CA125,pathologic type,ovarianmetastasis;single factor and multiple factors analysis of ovarian endometrial carcinoma metastasis factors. Results Patientsolder than 45 years old have 167 cases,of which there are 13 cases of ovarian metastasis,accounting for 7.78% of thetotal,39 cases of age less than 45 years old,of which there are 3 cases of ovarian metastasis,accounting for 7.69% of thetotal. There were 24 cases of special cases,4 cases of ovarian metastasis,accounting for 16.67% of the total,182 cases ofendometrial adenocarcinoma of the uterus,there were 11 cases of ovarian metastasis,accounting for 6.04% of the total. Inpatients with clinical stage before surgery in 5 cases,the occurrence of ovarian metastasis in 3 cases;clinical stage Ⅲ 13 cases,ovarian metastasis in 6 cases;clinical stage in 40 cases,the occurrence of ovarian metastasis in 3 cases;clinicalstage of 128 cases had ovarian metastasis there were 3 cases. The positive and low degree of differentiation of patients withCA125 were independent risk factors for ovarian metastasis(P<0.05). Conclusion Disease type,parametrial metastasis,tumor grade,lymph node metastasis and pelvic floor muscle erosion degree of endometrial cancer is the main influencingfactors of ovarian metastasis,preoperative assessment to determine whether to retain ovarian strictly.更多还原