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投稿时间：2021-07-14 网络发布日期：2022-02-20
投稿时间：2021-07-14 网络发布日期：2022-02-20
中文摘要: 目的 探讨术前外周血中性粒细胞与淋巴细胞比值（NLR）及血小板与淋巴细胞比值（PLR）、CA125、脉管癌栓、肌层浸润等对子宫内膜癌患者行淋巴结清扫决策的临床价值。方法 收集2019年4月至2021年4月潍坊医学院附属医院收治的102例子宫内膜癌患者的临床病理资料，患者术前均行血常规、CA125、MRI检查，术前5 min均宫颈注射纳米炭2 ml，后行腹腔镜手术，均行前哨淋巴结（SLN）切除及系统淋巴结清扫。采用多因素Logistic回归分析筛选出高危因素行ROC曲线分析。结果 102例患者中，SLN阳性22例（21.6%），SLN阴性80例（78.4%)。多因素Logistic回归分析显示，CA125≥35 μ/ml（P=0.016，OR=4.873，95%CI=1.352～17.570）、脉管癌栓(P=0.004，OR=7.891，95%CI=1.956～31.832)、肌层浸润≥1/2(P=0.003，OR=13.714,95%CI=2.410～78.034)是SLN转移的独立影响因素。ROC曲线分析发现三因素联合预测SLN转移的AUC最高，为0.892。结论 用无创检查术前外周血CA125水平联合术中脉管癌栓、肌层浸润预测SLN转移具有高度敏感性和准确性,此种预测模型是简单、有效的诊断方法。
Abstract:Objective To investigate the clinical value of preoperative peripheral blood neutrophil/lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), CA125, vascular tumor thrombus， myometrial invasion in endometrial carcinoma patients undergoing lymph node dissection to provide more accurate diagnosis and treatment. Methods The clinicopathological data of 102 patients with endometrial carcinoma treated in the Affiliated Hospital of Weifang Medical College from April 2019 to April 2021 were collected. The detections of blood routine, CA125 and MRI were conducted in all patients before operation, and carbon nanoparticles suspension injection (2 ml) was injected into the cervix 5 minutes before operation. The laparoscopic surgery with SLN resection and systematic lymph node dissection was performed. Multivariate Logistic regression analysis was used to screen the high-risk factors of SLN metastasis, and ROC curve analysis was performed. Results There were 22 cases of SLN positive (21.6%) and 80 cases of SLN negative (78.4%). Multivariate Logistic regression analysis showed that CA125 level≥35 μ/ml (P=0.016,OR=4.873,95%CI：1.352-17.570)，vascular tumor thrombus(P=0.004,OR=7.891,95%CI ：1.956-31.832), myometrial invasion≥1/2 (P=0.003,OR=13.714,95%CI： 2.410-78.034) were the independent influencing factors of SLN metastasis. ROC curve analysis showed that the AUC achieved by combined prediction of the three factors was 0.892. Conclusion Preoperative CA125 level combined with vascular tumor thrombus， myometrial invasion has high sensitive and accurate in prediction of sentinel lymph node metastasis.
keywords: Endometrial adenocarcinoma CA125 Carbon nanoparticles suspension injection Sentinel lymph node Receiver operating characteristic curve
文章编号： 中图分类号：R71 文献标志码：A
基金项目:山东省医药卫生科技发展计划项目（202005010475）
| Author Name | Affiliation |
| CHEN Xi*， WANG Ting-heng, WANG Xin-bo， et al | *Weifang Medical University， Weifang， Shandong 261053， China |
引用文本：
陈曦,王廷恒,王新波,等.CA125、脉管癌栓、肌层浸润预测子宫内膜癌前哨淋巴结转移[J].中国临床研究,2022,35(2):177-181.
陈曦,王廷恒,王新波,等.CA125、脉管癌栓、肌层浸润预测子宫内膜癌前哨淋巴结转移[J].中国临床研究,2022,35(2):177-181.