引用本文:王 伟,于 水,宋 波,王亚萍.52例伴MELF模式子宫内膜样癌的临床及病理特点分析[J].大连医科大学学报,2022,44(1):24-30.
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52例伴MELF模式子宫内膜样癌的临床及病理特点分析
王 伟1, 于 水2, 宋 波3, 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
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
DOI:10.11724/jdmu.2022.01.05
分类号:R737.33
基金项目:
Clinical and pathological features of 52 cases of endometrioid carcinoma with MELF pattern
WANG Wei1, YU Shui2, SONG Bo3, WANG Yaping1
1.Department of Pathology, Chunliu Maternity Campus, Dalian Women's and Children's Medical Center (Group),Dalian 116033,China;2.Department of Pathology, Sports New Town Campus,Dalian Women's and Children's Medical Center (Group),Dalian 116037,China;3.Department of Pathology, School of Basic Medicine, Dalian Medical University, Dalian 116044,China
Abstract:
Objective  To investigate the clinicopathological features and prognosis of endometrioid carcinoma with microcapsule, elongated and fragmented (MELF). Methods  The 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. Results  Compared 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. Conclusion  The endometrioid carcinoma with MELF pattern would not related to poor prognosis, though high invasiveness were often found.
Key words:  MELF  endometrioid carcinoma  transfer  prognosis