摘要
目的探讨腹主动脉旁淋巴结切除术在Ⅰ型子宫内膜癌患者全子宫双附件切除术中的应用效果。方法选取西南医科大学附属医院自2016年1月至2018年3月收治的91例I型子宫内膜癌患者为研究对象。根据是否行腹主动脉旁淋巴结切除术将患者分为A组(n=36,未行腹主动脉旁淋巴结切除术)与B组(n=55,行腹主动脉旁淋巴结切除术)。记录并比较两组患者的围术期指标和预后情况。比较两组患者手术前后肿瘤标志物[癌胚抗原(CEA)、人附睾蛋白4(HE4)、癌抗原125(CA125)、癌抗原19-9(CA19-9)]、生化指标[中性粒细胞/淋巴细胞(NLR)、D二聚体(D-D)]。结果B组患者手术时间、淋巴结清扫数量、住院时间均大于A组,差异均有统计学意义(P<0.05)。两组患者术后CEA、HE4、CA125、CA19-9及NLR、D-D均降低,且B组均低于A组,差异均有统计学意义(P<0.05)。B组患者3年、5年存活率均高于A组,但差异无统计学意义(P>0.05);A组患者复发率高于B组,差异有统计学意义(P<0.05)。结论在Ⅰ型子宫内膜癌患者全子宫双附件切除术中行腹主动脉旁淋巴结切除术,能够降低肿瘤标志物水平、生化指标水平及复发率。
Objective To investigate the effect of para-aortic lymphadenectomy in total double-adnexectomy of endometrial carcinoma type I.Methods A total of 91 patients with type I endometrial cancer admitted to Affiliated Hospital of Southwest Medical University from January 2016 to March 2018 were selected as the study objects.Patients were divided into group A(n=36,no para-aortic lymphadenectomy)and group B(n=55,para-aortic lymphadenectomy)according to whether para-aortic lymphadenectomy was performed.The perioperative indexes[carcino-embryonic antigen(CEA),human epididymis protein 4(HE4),cancer antigen 125(CA125),cancer antigen 19-9(CA19-9)]and biochemical indexes[neutrophil/lymphocyte ratio(NLR),D-dimer(D-D)]were compared between the two groups before and after surgery.Results The operation time,the number of lymph node dissection and the length of hospital stay in group B were higher than those in group A,with statistical significance(P<0.05).CEA,HE4,CA125,CA19-9,NLR and D-D were all decreased in two groups after surgery,and group B was lower than group A,with statistical significance(P<0.05).The three-year and five-year survival rates of group B were higher than those of group A,but the difference was not statistically significant(P>0.05).The recurrence rate of group A was higher than that of group B,and the difference was statistically significant(P<0.05).Conclusion Paraaortic lymphadenectomy during total hysterectomy of double adnexes in patients with type I endometrial cancer can reduce the level of perioperative indexes,biochemical indexes and recurrence rate.
作者
王欢
毛熙光
牟姗
李俊玫
刘洁曦
王露
WANG Huan;MAO Xi-guang;MOU Shan;LI Jun-mei;LIU Jie-xi;WANG Lu(Department of Obstetrics and Gynecology,School of Clinical Medicine,Southwest Medical University,Luzhou 646000,China)
出处
《临床军医杂志》
CAS
2024年第4期365-368,共4页
Clinical Journal of Medical Officers
基金
四川省中医药管理局科学技术研究专项课题(2023MS524)。
