Analysis Of Lymph Node Metastasis And Risk Factors In Type ? Endometrial Carcinoma

Objective: The aim of this study to Explor lymph node metastasis(LNM)of type ? endometrial cancer(EC)and risk factors,in order to provide evidence for the reasonable operation range and further individualize treatment.Methods: We Retrospectively studied patients with type ? EC who were admitted to the Hunan Provincial Cancer Hospital from January 1,2014 to December 31,2018,and who were diagnosed by pathology.All EC patients were underwent complete stage operation in our hospital.we collected the clinical data of 653 patients with type ? EC to reference,record and analyze in detail.The EXCEL database was established and the factors affecting LNM were analyzed by single factor and multi-factor.All data were statistically analyzed using SPSS 17.0 statistical software.Single factor analysis was performed by chi-square test or Fisher exact probability method.Multivariate analysis was performed by Logistic regression model.P<0.05 is statistically significant.Result:1.A total of 653 patients with type?EC were enrolled in this study.There were 58 cases of pelvic lymph node metastasis(PLNM)andpara-aortic lymph node metastasis(PANM).The lymph node metastasis rate was 8.9%.There were 35 patients of PLNM individually,with a lymph node metastasis rate of 5.3%,5 patients of PANM individually had a lymph node metastasis rate of 0.8%,18 patients both PLNM and PANM had a lymph node metastasis rate of 2.8%.PLNM is most likely to appear in obturator lymph nodes with a metastatic rate of 7.7%.In addition,the metastasis of obturator lymph nodes,the metastasis of common iliac lymph nodes and external iliac lymph nodes was correlated with the metastasis of PANM(P<0.05).2.The single factor analysis showed that poorly differentiated,tumor diameter?2cm,muscular infiltration(MI)?1/2,cervical interstitial involvement,carbohydrate antigen 125(CA125)?35U/ml,parametrial or vaginal involvement,lymphatic vascular space infiltrates(LVSI)positive,and accessory metastasis were associated with LNM of type ? EC.Multi-factor analysis showed that poorly differentiated,tumor diameter?2cm,MI?1/2,cervical interstitial involvement,CA125?35U/ml were independent risk factor for type?endometrial cancer LNM(P<0.05).3.The single factor analysis of 23 patients with type?EC with in this study showed poorly differentiated,tumor diameter?2 cm,MI?1/2,cervical interstitial involvement,CA125?35U/ml,parametrial or vaginal involvement,LSVI positive,attachment transfer is related to PANM.Multivariate analysis showed that PLNM was independent risk factor for type?endometrial cancer PANM of type?EC.Conclusion:1.The overall metastatic rate of lymph nodes in type ?EC is low,and obturator lymph nodes are common sites of PLNM.2.Type ? EC can be transferred to the para-aortic lymph nodes directly,and the obturator lymph nodes metastasis,common peroneal lymph nodes metastasis,and extra-orbital lymph nodes metastasis in the pelvic lymph nodes metastasis are associated with PANM.3.Low-differentiation,tumor diameter?2cm,MI?1/2,cervical interstitial involvement,CA125?35U/ml are independent risk factors for LNM of type ?EC,and PLNM is an independent risk factor for PANM in type?EC patients.