I 期子宫内膜样癌输卵管腔内肿瘤细胞集群的预后价值

IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY International Journal of Gynecological Pathology Pub Date : 2024-06-25 DOI:10.1097/PGP.0000000000001054
Ye Jin Yoo, Yeon Joo Kim, Yong-Man Kim, Kyu-Rae Kim, Uiree Jo, Young Seok Kim
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引用次数: 0

摘要

本研究旨在探讨I期子宫内膜样癌(EEC)女性患者的病理预后因素,如输卵管腔内的肿瘤细胞簇(TCC)、子宫肌层浸润模式和腹膜细胞学(PPC)阳性。研究纳入了2009年至2020年期间连续接受子宫切除术和双侧输卵管切除术的I期EEC患者。主要结果是无复发生存率(RFS),并分析了影响RFS的临床病理因素。共有 765 名患者入选。17名患者(2.2%)的输卵管腔内有TCC,58名患者(7.6%)的输卵管呈微囊状拉长和碎裂。19名患者(2.5%)发现了PPC。中位随访时间为 61.0 个月(2.0-149.7 个月)。大多数患者(88.6%)的EEC为IA期。5年RFS和总生存率分别为97.5%和98.5%。在RFS的多变量分析中,重要的预后因素是淋巴管侵犯(危险比=4.604;95% CI:1.387-15.288;P=0.013)和分级(2级;危险比=4.949;95% CI:1.035-23.654;P=0.045;3级;危险比=5.469;95% CI:1.435-20.848;P=0.013)。其他病理因素,包括输卵管腔内的TCC、子宫肌层侵袭模式、PPC和激素状况,均无预后意义。输卵管腔内的 TCC、子宫肌层侵袭模式、PPC 以及雌激素和孕激素受体阳性对 I 期 EEC 的预后无显著意义。相反,淋巴管侵犯和分级则是重要的预后因素。
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The Prognostic Value of Tumor Cell Clusters in the Fallopian Tube Lumen in Stage I Endometrioid Carcinoma.

The aim of this study was to investigate the pathologic prognostic factors such as tumor cell clusters (TCCs) in the fallopian tube lumen, myometrial invasion patterns, and positive peritoneal cytology (PPC) in women with Stage I endometrial endometrioid carcinoma (EEC). From 2009 to 2020, consecutive patients with Stage I EEC who underwent hysterectomy and bilateral salpingectomy were included. The primary outcome was the recurrence-free survival (RFS) rate, and the clinicopathological factors affecting RFS were analyzed. A total of 765 patients were enrolled. Seventeen patients (2.2%) had TCC in the fallopian tube lumen, and 58 patients showed a microcystic elongated and fragmented pattern (7.6%). PPC was found in 19 patients (2.5%). The median follow-up period was 61.0 months (range: 2.0-149.7). The majority (88.6%) of patients had Stage IA EEC. The 5-year RFS and overall survival rates were 97.5% and 98.5%, respectively. In multivariate analysis for RFS, the significant prognostic factors were lymphovascular invasion (hazard ratio = 4.604; 95% CI: 1.387-15.288; P = 0.013) and grade (grade 2; hazard ratio = 4.949; 95% CI: 1.035-23.654; P = 0.045, and grade 3; hazard ratio = 5.469; 95% CI: 1.435-20.848; P = 0.013). Other pathologic factors including TCC in the fallopian tube lumen, myometrial invasion patterns, PPC, and hormonal status had no prognostic significance. TCC in the fallopian tube lumen, myometrial invasion pattern, PPC, and estrogen and progesterone receptor positivity were not significant prognostic factors in Stage I EEC. In contrast, lymphovascular invasion and grade were significant prognostic factors.

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来源期刊
CiteScore
3.90
自引率
12.50%
发文量
154
审稿时长
6-12 weeks
期刊介绍: International Journal of Gynecological Pathology is the official journal of the International Society of Gynecological Pathologists (ISGyP), and provides complete and timely coverage of advances in the understanding and management of gynecological disease. Emphasis is placed on investigations in the field of anatomic pathology. Articles devoted to experimental or animal pathology clearly relevant to an understanding of human disease are published, as are pathological and clinicopathological studies and individual case reports that offer new insights.
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