不同危险度分级子宫内膜间质瘤患者生存以及预后影响因素分析
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摘要
目的探讨低度恶性和高度恶性子宫内膜间质瘤患者生存和预后的影响因素。方法回顾性分析2007年1月—2012年4月就诊确诊为子宫内膜间质瘤的94例患者资料,其中低度恶性69例,高度恶性25例。术后随访5年,截止至2017年5月,分析患者3年、5年的生存情况与临床病理特征的关系,利用Cox风险比例模型分析其预后影响因素。结果低度恶性子宫内膜间质瘤患者3年、5年生存率分别为91.3%,85.5%,高度恶性子宫内膜间质瘤患者3年、5年生存率分别为52.0%,24.0%,经Cox风险比例回归模型分析后,年龄、FIGO分期是影响低度恶性子宫内膜间质瘤患者的预后独立影响因素,年龄、FIGO分期、绝经状态、术后辅助放化疗是影响高度恶性子宫内膜间质瘤患者预后的独立影响因素。结论年龄、FIGO分期、绝经状态、术后辅助放化疗是影响不同危险度分级子宫内膜间质瘤患者预后的影响因素。
Objective It is to investigate the prognostic factors for survival and prognosis in patients with low-grade and highly malignant endometrial stromal tumors. Methods A retrospective analysis of 94 patients with endometrial stromal tumors diagnosed in our hospital from January 2007 to April 2012, including 69 cases of low malignancy and 25 cases of high malignancy were performed. The patients were followed up for 5 years. By the end of May 2017, the relationship between the 3 years and 5 years of survival and clinicopathological features was analyzed. The prognostic factors were analyzed by Cox proportional hazard model. Results The 3-year and 5-year survival rates of patients with low-grade endometrial stromal tumors were 91.3% and 85.5%, respectively. The 3-year and 5-year survival rates of patients with highly malignant endometrial stromal tumors were 52.0% and 24.0%, respectively. The Cox risk proportional regression model analysis showed that age and FIGO stage were the independent prognostic factors which influence the patients with low-grade malignant endometrial stromal tumors, Age, FIGO stage, menopausal status, postoperative adjuvant chemotherapy and radiotherapy were the most important independent prognostic factors for high-grade malignant endometrial stromal tumors. Conclusion Age, FIGO stage, menopausal status, postoperative adjuvant chemoradiotherapy are the influencing factors affecting the prognosis of patients with different risk graded endometrial stromal tumors.
Objective It is to investigate the prognostic factors for survival and prognosis in patients with low-grade and highly malignant endometrial stromal tumors. Methods A retrospective analysis of 94 patients with endometrial stromal tumors diagnosed in our hospital from January 2007 to April 2012, including 69 cases of low malignancy and 25 cases of high malignancy were performed. The patients were followed up for 5 years. By the end of May 2017, the relationship between the 3 years and 5 years of survival and clinicopathological features was analyzed. The prognostic factors were analyzed by Cox proportional hazard model. Results The 3-year and 5-year survival rates of patients with low-grade endometrial stromal tumors were 91.3% and 85.5%, respectively. The 3-year and 5-year survival rates of patients with highly malignant endometrial stromal tumors were 52.0% and 24.0%, respectively. The Cox risk proportional regression model analysis showed that age and FIGO stage were the independent prognostic factors which influence the patients with low-grade malignant endometrial stromal tumors, Age, FIGO stage, menopausal status, postoperative adjuvant chemotherapy and radiotherapy were the most important independent prognostic factors for high-grade malignant endometrial stromal tumors. Conclusion Age, FIGO stage, menopausal status, postoperative adjuvant chemoradiotherapy are the influencing factors affecting the prognosis of patients with different risk graded endometrial stromal tumors.
引文
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[11] Xie W,Cao D,Yang J,et al. Fertility-sparing surgery for patients with low-grade endometrial stromal sarcoma[J]. Oncotarget,2017,8(6):10602-10608
[12] 刘琦,钱敏,张承,等. 子宫内膜间质肉瘤:从Ⅰ期低级别转化为Ⅳ期高级别肿瘤的临床病理分析[J]. 临床与实验病理学杂志,2016,32(5):523-527
[13] Kanda M,Sonoyama A,Hirano H,et al. Transition of low-grade to high-grade endometrial stromal sarcoma:a case report[J]. Eur J Gynaecol Oncol,2013,34(4):358-361
[2] 佟晓晶,李联昆. 子宫肉瘤临床特点及预后相关因素101例分析[J]. 中国实用妇科与产科杂志,2014,30(11):898-901
[3] 喇慧,韦贞汁,曲丽霞,等. 子宫内膜间质肉瘤和低分化子宫内膜样腺癌的病理特征及鉴别诊断[J]. 现代肿瘤医学,2017,25(5):782-784
[4] Feng W,Malpica A,Robboy SJ,et al. Prognostic value of the diagnostic criteria distinguishing endometrial stromal sarcoma,low grade from undifferentiated endometrial sarcoma, 2 entities within the invasive endometrial stromal neoplasia family[J]. Int J Gynecol Pathol,2012,31(2):151-158
[5] 仰晨. 低度恶性子宫内膜间质肉瘤临床病理特征及误诊原因探析[J]. 现代肿瘤医学,2015,23(11):1568-1570
[6] A’Hern RP. Restricted Mean Survival Time:An Obligatory End Point for Time-to-Event Analysis in Cancer Trials[J]. J Clin Oncol,2016,34(28):3474-3476
[7] Borg CS,Humaidan P,Noer H,et al. Endometrial Stromal Nodule: A Rarity and a Pathological Challenge[J]. Case Rep Obstet Gynecol,2015,2015:376817
[8] 谷旸,周欣. 620例子宫内膜间质肉瘤临床特征的系统评价[J]. 中国现代医学杂志,2012,22(10):88-92
[9] Seagle BL,Kanis M,Strohl AE,et al. Survival of women with Mullerian adenosarcoma: A National Cancer Data Base study[J]. Gynecol Oncol,2016,143(3):636-641
[10] Seagle BL,Shilpi A,Samuel Buchanan C,et al. Low-grade and high-grade endometrial stromal sarcoma: A National Cancer Database study[J]. Gynecol Oncol,2017,146(2):254-262
[11] Xie W,Cao D,Yang J,et al. Fertility-sparing surgery for patients with low-grade endometrial stromal sarcoma[J]. Oncotarget,2017,8(6):10602-10608
[12] 刘琦,钱敏,张承,等. 子宫内膜间质肉瘤:从Ⅰ期低级别转化为Ⅳ期高级别肿瘤的临床病理分析[J]. 临床与实验病理学杂志,2016,32(5):523-527
[13] Kanda M,Sonoyama A,Hirano H,et al. Transition of low-grade to high-grade endometrial stromal sarcoma:a case report[J]. Eur J Gynaecol Oncol,2013,34(4):358-361