摘要
目的对比分析合并子宫腺肌病(adenomyosis,ADM)的子宫内膜癌(endometrial carcinoma,EC)与单纯EC的临床及病理特征,探讨2种妇科疾病共存时的特殊性及内在联系。方法本研究采用回顾性研究设计,选取2023年1月—2024年5月在河北医科大学第二医院接受手术,病理为EC的患者作为研究对象。根据是否合并子宫腺肌病分组,对2组临床表现、术前检查以及术后病理结果进行系统性比较分析。结果总计纳入患者249例,合并ADM的EC观察组共41例(16.5%),单纯EC的对照组共208例(83.5%)。2组一般资料对比,观察组体重指数(body mass index,BMI)低于对照组,差异有统计学意义(25.14 vs.27.07,P=0.034);观察组合并糖尿病概率低于对照组,差异有统计学意义(9.8%vs.23.6%,P=0.048);2组在年龄、体重、身高、孕次、产次、流产次数、绝经状态以及其他合并症(包括高血压和血栓栓塞性疾病)等特征方面差异无统计学意义(P=0.504、0.054、0.910、0.898、0.215、0.064、0.285、0.379、1.000)。2组临床表现对比,差异无统计学意义(P=0.521)。2组术前MRI内膜情况及宫腔占位对比,差异无统计学意义(P=0.900、0.276)。2组术前肿瘤标记物糖类抗原125(carbohydrate antigen 125,CA125)、糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)、人附睾蛋白4(human epididymis protein 4,HE4)对比,差异无统计学意义(P=0.509、0.259、0.623)。2组病理结果提示观察组中脉管浸润的比例低于对照组,差异有统计学意义(2.4%vs.13.9%,P=0.039),2组在病理分期、肌层浸润、淋巴结转移方面差异均无统计学意义。2组免疫组织化学结果对比,在Ki-67、微卫星稳定性、P53、雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)方面差异均无统计学意义(P=0.268、0.606、0.329、1.000、0.553)。结论EC合并ADM患者易具有较低的BMI、较低的糖尿病合并率和较低的脉管浸润比例。
Objective To compare and analyze the clinical and pathological characteristics between endometrial carcinoma(EC)complicated with adenomyosis(ADM)and simple endometrial carcinoma EC,and to explore the particularity and intrinsic relationship when the two gynecological diseases coexist.Methods A retrospective study design was adopted in this study,and patients with pathologically confirmed EC who underwent surgery in the second hospital of Hebei Medical University from January 2023 to May 2024 were selected as the research subjects.They were divided into two groups based on whether they were complicated with adenomyosis.The clinical manifestations,preoperative examinations,and postoperative pathological results of the two groups were systematically compared and analyzed.Results Of 249 patients enrolled,there were 41 patients(16.5%)in the observation group with EC complicated with adenomyosis and 208 patients(83.5%)in the control group with simple EC.Comparison of general data was performed between the two groups.The body mass index(BMI)of the observation group was lower than that of the control group,with a significant difference(25.14 vs.27.07,P=0.034),and the probability of diabetes in the observation group was lower than that in the control group,showing a significant difference(9.8%vs.23.6%,P=0.048).There were no significant differences between the two groups in terms of age,weight,height,gravidity,parity,number of abortions,menopausal status and other comorbidities(including hypertension and thromboembolic disease)(P=0.504,0.054,0.910,0.898,0.215,0.064,0.285,0.379,1.000).There was no significant difference in clinical manifestations between the two groups(P=0.521),nor difference in preoperative MRI findings of endometrium and intrauterine space-occupying lesions between the two groups(P=0.900,0.276).Preoperative comparison of tumor markers carbohydrate antigen 125(CA125),carbohydrate antigen 19-9(CA19-9)and human epididymis protein 4(HE-4)between the two groups showed no statistical significance(P=0.509,0.259,0.623).Compared with the pathological results of the two groups,the proportion of vascular infiltration in the observation group was lower than that in the control group,suggesting significant differences(2.4%vs.13.9%,P=0.039).There were no significant differences in pathological stage,muscular infiltration and lymph node metastasis between the two groups.Immunohistochemical results of the two groups showed no significant differences with respect to Ki-67,microsatellite stability,P53,estrogen receptor and progesterone receptor(P=0.268,0.606,0.329,1.000,0.553).Conclusion Patients with EC complicated with adenomyosis have lower BMI,lower rate of combined diabetes,and lower proportion of vascular infiltration.
作者
闫璐
刘义彬
张志强
杜飞达
牛昆明
YAN Lu;LIU Yi-bin;ZHANG Zhi-qiang;DU Fei-da;NIU Kun-ming(Department of Gynecology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)
出处
《河北医科大学学报》
2025年第11期1290-1296,共7页
Journal of Hebei Medical University
基金
河北省省级科技计划(236Z7717G)
河北省医学科学研究课题计划(20240730)
河北省中医药管理局科研计划项目(2024272)。
关键词
子宫内膜癌
子宫腺肌病
病理特征
endometrial carcinoma
adenomyosis
pathological characteristics
