国际妇产科学杂志

国际妇产科学杂志 ›› 2016, Vol. 43 ›› Issue (3): 353-356.

• 论著 • 上一篇    下一篇

子宫肉瘤与癌肉瘤预后相关因素的分析

叶丹，袁蕾，尧良清   

  1. 200011 上海，复旦大学附属妇产科医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2016-06-22 发布日期:2016-06-22
  • 通讯作者: 袁蕾

The Analysis of the Prognositic Factors between Uterine Sarcoma and Carcinosarcoma

YE Dan，YUAN Lei，YAO Liang-qing   

  1. Obstetrics and Gynecology Hospital，Fudan University，Shanghai 200011，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2016-06-22 Online:2016-06-22
  • Contact: YUAN Lei

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摘要： 目的：探讨子宫肉瘤与癌肉瘤的临床特征及预后的相关因素。方法：回顾性分析2003年1月—2012年12月于复旦大学附属妇产科医院且经手术病理确诊为子宫肉瘤或癌肉瘤的168例患者的临床资料，随访其生存及复发情况。Kaplan-Meier法绘制生存曲线并进行单因素生存分析，Log-rank检验比较2组或多组生存情况，Cox比例风险回归模型进行多因素分析筛选预后相关的危险因素。结果：子宫肉瘤和癌肉瘤患者中位生存时间分别为（125.76±4.99）个月和（86.65±7.84）个月，子宫肉瘤患者总生存期（overall survival，OS）长于癌肉瘤患者（P=0.003）。Cox多因素回归分析显示，肿瘤病理分期是影响子宫肉瘤OS的危险因素（P=0.006），而病理分期[OS P=0.002，无进展生存期（progress-free survival，PFS）P=0.007]和淋巴结清扫（OS P=0.042，PFS P=0.042）是影响癌肉瘤的危险因素。结论：子宫肉瘤较癌肉瘤预后好，其中肿瘤病理分期越晚，子宫肉瘤与癌肉瘤的OS越短。而对于癌肉瘤，除了肿瘤病理分期外，淋巴结清扫不仅可以显著延长癌肉瘤的OS，还可以提高患者PFS。

关键词: 子宫肿瘤, 癌肉瘤, 淋巴结切除术, 无病生存, 子宫肿瘤, 癌肉瘤, 淋巴结切除术, 无病生存

Abstract: Objective： To compare the clinical characteristic and prognositic factors between uterine sarcoma and carcinosarcoma. Methods：By performing a retrospective analysis，we identified 168 women with pathology identified as uterine sarcoma or carcinosarcoma by Obstetrical and Gynecological Hospital of Fudan University from January 2003 to December 2012，and analysed their clinical information and follow up mortality and recurrence. Kaplan-Meier used to draw survival line and do single factor analysis，Log-rank test to compare two or more groups′ survival difference，multi-factor cox-regreesion model to screen the risk factors of prognosis. Results：Uterine sarcoma and carcinosarcoma′s median survival time were（125.76±4.99） months and （86.65±7.84） months respectively. Uterine sarcoma′s overall survival（OS） is significantly longer than carcinosarcoma（P=0.003），according to Cox multi-factors regression analysis，the risk factor for uterine sarcoma′s OS is tumor pathological stage（P=0.006），the risk factors for carcinosarcoma′s OS and progress-free survival （PFS） are not only stage（OS P=0.002，PFS P=0.007），but also lympha-node dissection（OS P=0.042，PFS P=0.042）. Conclusions： Compare to carcinosarcoma，uterine sarcoma have a better prognosis，it has a longer survival time for uterine sarcoma，the later tumor pathological stage，the shorter OS. For carcinosarcoma，not only the stage，lympha-node dissection can also improve their OS，and delay recurrence significantly.

Key words: Uterine neoplasms, Carcinosarcoma, Lymph node excision, Disease-free survival, Uterine neoplasms, Carcinosarcoma, Lymph node excision, Disease-free survival