王伟^1,,
于水²,
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王亚萍^1,,
1. 大连市妇女儿童医疗中心(集团)春柳妇产院区 病理科，辽宁 大连 116033
2. 大连市妇女儿童医疗中心(集团)体育新城院区 病理科，辽宁 大连 116037
3. 大连医科大学 病理学与法医学教研室，辽宁 大连 116044

详细信息 作者简介: 王伟(1985-), 男, 主治医师。E-mail: 781138366@qq.com




通讯作者: 王亚萍, 主任医师。E-mail: dlfcwyp@163.com 中图分类号: R737.33


摘要:目的探讨伴微囊、拉长、碎片化(microcystic, elongated, fragmented, MELF)模式子宫内膜样癌的临床病理特征及预后。方法回顾性收集大连市妇女儿童医疗中心(集团)309例子宫内膜样癌患者资料，其中52例为伴MELF模式子宫内膜样癌，257例为非MELF模式子宫内膜样癌。分析两种模式临床病理特征和预后差异。临床病理数据比较采用χ²和t检验。Logistic回归分析子宫内膜样癌淋巴结转移的相关危险因素；基于Kaplan-Meier方法分析5年生存情况，并使用对数秩检验比较结果差异。结果MELF模式与非MELF模式相比，绝经人数(χ²=4.925，P=0.026)、术前血清CA125水平(χ²=13.197，P < 0.001)、宫颈管间质侵犯(χ²=7.188，P=0.007)、浸润肌层深度(χ²=21.749，P < 0.001)、脉管侵犯(χ²=43.784，P < 0.001)、淋巴结转移(χ²=53.268，P < 0.001)及FIGO分期(χ²=55.116，P < 0.001)差异均有统计学意义。多变量logistic分析显示，宫颈管间质侵犯(OR=3.953；95%CI：1.590~9.829；P=0.003)、脉管侵犯(OR=11.421；95%CI：3.174~41.097；P＜0.001)和MELF模式(OR=5.830；95%CI：2.442~13.922；P＜0.001)是影响子宫内膜样癌淋巴结转移的独立因素。与非MELF模式相比，伴MELF模式子宫内膜样癌的5年总生存率(OS)和无进展生存率(DFS)均无明显差异(P＞0.05)。结论虽然伴MELF模式子宫内膜样癌的临床病理特征与高侵袭性相关，但与非MELF模式的预后相比，无明显差异。
关键词: MELF/
子宫内膜样癌/
转移/
预后


Abstract:ObjectiveTo investigate the clinicopathological features and prognosis of endometrioid carcinoma with microcapsule, elongated and fragmented (MELF).MethodsThe data of 309 patients with endometrioid carcinoma in Dalian Women's and Children's Medical Center (Group) were collected, including 52 cases of endometrioid carcinoma with MELF pattern and 257 cases of endometrioid carcinoma without MELF pattern. The clinicopathological features and prognosis of the two groups were analyzed statistically.ResultsCompared with non MELF pattern endometrioid carcinoma, it was significantly higher in the numbers of menopausal patients (χ²=4.925, P=0.026), preoperative serum CA125 level (χ²=13.197, P < 0.001), cervical interstitial invasion (χ²=7.188, P=0.007), depth of invasive muscle layer (χ²=21.749, P < 0.001), vascular invasion (χ²=43.784, P < 0.001), lymph node metastasis (χ²=53.268, P < 0.001) and FIGO staging (χ²=55.116, P < 0.001) of endometrioid carcinoma with MELF pattern. However, there was no significant difference in 5-year overall survival (OS) and disease free survival (DFS) between the two groups.ConclusionThe endometrioid carcinoma with MELF pattern would not related to poor prognosis, though high invasiveness were often found.
Keywords:MELF/
endometrioid carcinoma/
transfer/
prognosis

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