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目的探讨Ⅰ期子宫内膜癌的淋巴结转移率及行腹膜后淋巴结清除术的意义。方法对３８例临床Ⅰ期子宫内膜癌患者临床、病理及随访资料进行回顾性研究，对照分析经行腹膜后淋巴清除术后，未发现淋巴转移者２２例，ＦＩＧＯⅠ期（Ａ组），有淋巴结转移者６例，ＦＩＧＯ升级为Ⅲｃ期（Ｂ组）及未行腹膜后淋巴清除的１０例（Ｃ组）。结果经腹膜后淋巴清除术的患者中２１４％（６／２８）有腹膜后淋巴结转移，因此期别应上升为Ⅲｃ期，且腹膜后淋巴结转移与肿瘤细胞分级及肌层浸润深度相关（Ｐ＜００５）。在平均３０２个月的随访中，Ａ、Ｂ两组无瘤生存率均为１０００％（２２／２２及６／６），Ｃ组中２例肿瘤复发死亡。无瘤生存率为８００％（８／１０），比较有淋巴结转移的Ｂ组６例及Ｃ组中２例的生存率，差异有显著性（Ｐ＜００５）。结论对临床分期为Ⅰ期的子宫内膜癌患者应常规行全子宫、双附件切除加腹膜后淋巴结清除术。
Objective To investigate the lymph node metastasis rate of stage Ⅰ endometrial carcinoma and the significance of retroperitoneal lymph node dissection. Methods The clinical, pathological and follow-up data of 38 patients with clinical stage Ⅰ endometrial cancer were retrospectively analyzed. Twenty-two patients without lymph node metastasis after retroperitoneal lymphadenectomy were analyzed. 6 cases of lymph node metastasis, FIGO upgrade to stage Ⅲc (group B) and no retroperitoneal lymph node dissection in 10 cases (group C). Results 21.4% (6/28) of patients with retroperitoneal lymphadenectomy had retroperitoneal lymph node metastasis, so the stage should be increased to Ⅲc stage, and the retroperitoneal lymph node metastasis was related to tumor cell grade and depth of myometrial invasion P <005). In a mean follow-up of 302 months, the tumor-free survival rates in group A and B were 1000% (22/22 and 6/6), respectively. Two of the tumor recurrences in group C died. The tumor-free survival rate was 800% (8/10). There was significant difference between the 6 cases in group B with lymph node metastasis and 2 cases in group C (P <005). Conclusion The clinical stage of endometrial cancer Ⅰ patients should routine routine uterus, double attachment resection plus retroperitoneal lymph node dissection.