探索子宫内膜间质肉瘤的临床预后因素

Exploring the clinical prognostic factors in endometrial stromal sarcoma

摘要:

目的 回顾性分析子宫内膜间质肉瘤（endometrial stromal sarcoma，ESS）患者的临床转归结果，探讨影响其预后的因素。方法 收集2009年6月至2020年3月重庆医科大学附属第一医院收治的82例ESS患者临床资料，统计患者年龄、体质指数（body mass index，BMI）、绝经状态、肿瘤大小、淋巴结切除、卵巢保留、组织学类型、分期、辅助治疗情况、CD10等，并对所有患者进行随访。采用统计学软件SPSS 25.0进行数据统计分析，Kaplan-Meier法和log-rank检验进行生存分析，通过Cox回归分析影响预后的因素。结果 82例ESS患者纳入研究，随访时间为2~132个月，5年累计总生存率为71.8%。通过单因素分析发现，绝经状态、是否保留卵巢、组织学类型、分期、雌激素受体（estrogen receptor，ER）、孕激素受体（progesterone receptor，PR）和Ki-67指数与无进展生存期（progression-free survival，PFS）显著相关，绝经状态、肿瘤大小、组织学类型、分期、ER、PR和Ki-67指数与总生存期（overall survival，OS）显著相关。其中，组织学类型和是否保留卵巢是影响PFS的独立预后因素（P=0.010、0.013），组织学类型是影响OS的独立预后因素（P=0.033）。结论 影响ESS预后的因素较多，组织学类型、是否保留卵巢是ESS的独立预后因素。

Abstract:

Objective To perform a retrospective analysis of the clinical outcome of patients with endometrial stromal sarcoma（ESS） and to identify prognostic factors.Methods A total of 82 ESS patients were recruited from June 2009 to March 2020 in The First Affiliated Hospital of Chongqing Medical University. Their clinical data were collected and analyzed，including age，body mass index，menopausal status，tumor size，lymph node resection，ovarian preservation，histological type，stage，adjuvant therapy，and CD10. All patients were followed up. Statistical analysis was performed using SPSS 25.0，the Kaplan-Meier method and log-rank test were used for survival analysis，and Cox regression was used to analyze the prognostic factors.Results A total of 82 patients with ESS were enrolled in this study. The follow-up time was 2-132 months，and the 5-year cumulative overall survival rate was 71.8%. Univariate analysis showed that menopausal status，ovarian preservation，histological type，stage，and indices（ER，PR，and Ki-67） were significantly correlated with progression-free survival. While menopause status，tumor size，histological type，stage，and indices（ER，PR，and Ki-67） were significantly correlated with overall survival. Histological type and ovarian preservation were independent prognostic factors for progression-free survival（P=0.010，0.013），while histological type was an independent prognostic factor for overall survival（P=0.033）.Conclusion There are many factors that affect the prognosis of ESS，and histological type and ovarian preservation are independent prognostic factors for ESS.