摘要
目的探讨子宫内膜癌扩散至盆腔和腹主动脉旁淋巴结的途径。方法对接受全子宫和盆腔淋巴结切除术的168例子宫内膜癌患者,准确记录肿瘤所处子宫腔位置、子宫肌层浸润深度、分期、病理类型、细胞学分级及切除淋巴结位置及阳性淋巴结数,并进行相关分析。结果肿瘤位于宫底部、宫体部、累及宫颈者子宫内膜癌淋巴结转移率分别是19.2%、20.6%、37.5%,均以髂外淋巴结转移为最常见。病灶局限于宫底、宫体部者多为髂外、闭孔淋巴结转移;累及宫颈者以髂外、髂总淋巴结转移为常见。前者髂总淋巴结转移率为30.8%,后者为66.7%,P<0.01。所有腹主动脉旁淋巴结阳性和累及宫颈者的髂总淋巴结均为阳性,而病灶限于宫体的腹主动脉旁淋巴结转移者仅有27%髂总淋巴结阳性。肌层浸润程度、病理类型及细胞分化程度与盆腔淋巴结转移密切相关。结论位于宫体部的肿瘤可直接或由宫颈转移至髂外淋巴结,宫颈受累者最易发生髂总和髂外淋巴结转移。病灶累及宫颈者髂总淋巴结可作为腹主动脉旁淋巴结的前哨淋巴结。
Objective To study the way the nodal metastasis of pelvic and para-aorticlymph node in endometrial carcinoma Method 168 cases with endometrial cancer treated by hysterectomy and pelvic Lymphadenectomy were reviewed and analyzed. Position,invasive degree,staging,pathologic type,cytodifferentiation of carcinoma and dissected lymphnode （LN） were recorded exactly and analysised. Results Transmation ratio were 19. 2% ,20. 6% ,37. 5% when carcinoma sited infundus,corpus uteri and cervix was invaded. Iliaca externa LN were invaded most commonly in all cases. Most iliaca extdrna and obturatoria LN were attacted when carcinoma sited in fundus, corpus; iliaca externa, communis LN used to be attacted when cervix was invaded. Transmation ratio of iliaca commumis LN was 30% in the former group, and 67% the later, P 〈 0. 01. All iliaca communis LN were invaded in which para-aortic lymphnode and cervix uteri were damaged, only 27% in thoes corpus uteri carcinoma with para-aortie lymph node transmation. There were significant correlations among invasive degree,pathologic types,eytodifferentiation wieh pelvie LN transmation. Conclusion It tended to be metastasized to node iliaca externa directlyor by cervix when carcinoma in corpus, but to node iliaca communis andinternamostly when cervix was invaded. Iliaca communis LN used to be damaged earlier than para-aorticlymph node in patients with cervix was invaded.
出处
《中国实用医药》
2009年第16期11-12,共2页
China Practical Medicine
关键词
子宫内膜肿瘤
淋巴结转移
手术
Endometrial neoplasms
Lymph node metastasis
Operation
