本文選題：子宮內(nèi)膜癌　切入點(diǎn)：卵巢轉(zhuǎn)移　出處：《現(xiàn)代婦產(chǎn)科進(jìn)展》2017年04期

【摘要】：目的:探討子宮內(nèi)膜癌發(fā)生卵巢轉(zhuǎn)移的發(fā)病率并分析其危險(xiǎn)因素,為年輕的子宮內(nèi)膜癌患者是否保留卵巢提供一定的理論依據(jù)。方法:檢索Pub Med、Embase、ISIweb of science、CNKI等數(shù)據(jù)庫中發(fā)表的相關(guān)中文和英文文獻(xiàn),截至2016年9月。通過隨機(jī)效應(yīng)模型合并相對危險(xiǎn)度RR(95%可信區(qū)間)進(jìn)行分析,包括組織學(xué)分級、盆腔淋巴結(jié)轉(zhuǎn)移、肌層浸潤深度、宮頸浸潤、子宮漿膜層浸潤、腹水細(xì)胞學(xué)、淋巴脈管浸潤、血清CA125水平和宮旁浸潤等。結(jié)果:初檢文獻(xiàn)124篇,最終納入8篇。Meta分析結(jié)果示,子宮內(nèi)膜癌發(fā)生卵巢轉(zhuǎn)移的高危因素有組織學(xué)分級(G3)(RR=2.09,95%CI為1.35~3.23)、盆腔淋巴結(jié)轉(zhuǎn)移(RR=4.46,95%CI為3.09~6.45)、深肌層浸潤(RR=3.02,95%CI為2.00~4.54)、宮頸浸潤(RR=2.77,95%CI為1.83~4.20)、子宮漿膜層浸潤(RR=16.93,95%CI為8.38~34.22)、腹水細(xì)胞學(xué)陽性(RR=4.16,95%CI為2.84~6.11)、脈管浸潤(RR=2.03,95%CI為1.11~3.69)、血清CA12535U/ml(RR=3.27,95%CI為2.22~4.81)、宮旁浸潤(RR=7.37,95%CI為3.89~13.97)。結(jié)論:約5%的子宮內(nèi)膜癌患者發(fā)生卵巢轉(zhuǎn)移。高組織學(xué)分級、盆腔淋巴結(jié)轉(zhuǎn)移、深肌層浸潤、宮頸浸潤、子宮漿膜層浸潤、腹水細(xì)胞學(xué)陽性、淋巴脈管浸潤、血清CA125水平35U/ml和宮旁浸潤是子宮內(nèi)膜癌發(fā)生卵巢轉(zhuǎn)移的高危因素。對于年輕的子宮內(nèi)膜癌患者,是否選擇保留卵巢應(yīng)謹(jǐn)慎,應(yīng)告知卵巢轉(zhuǎn)移的潛在風(fēng)險(xiǎn),充分做好術(shù)前及術(shù)中評估,如無高危因素,可考慮保留卵巢。
[Abstract]:Methods: Chinese and English literatures published in Pub Medbase of Science and other databases were searched as of September 2016.The RRN 95% confidence interval (RRN 95% confidence interval) was used to analyze, including histological grade, pelvic lymph node metastasis, depth of myometrial infiltration, cervix infiltration, serous infiltration, ascites cytology, lymphatic vessel infiltration.Serum CA125 level and para-uterine infiltration.Results: 124 articles were first examined, and 8 papers were included. The results of meta-analysis showed that,瀛愬鍐呰啘鐧屽彂鐢熷嵉宸㈣漿縐葷殑楂樺嵄鍥犵礌鏈夌粍緇囧鍒嗙駭(G3)(RR=2.09,95%CI涓，

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