Clinicopathological Characteristics And Prognosis Analysis Of Lymph Node Metastasis And Ovarian Metastasis In Stage Ⅰ-Ⅲ Endometrial Cancer

Aims: To analyze the clinical and prognostic characteristics of patients with FIGO stage I-III endometrial cancer in our center in the past 10 years.To explore the clinicopathological factors associated with lymph node metastasis,ovarian metastasis and poor prognosis in endometrial cancer patients.Methods:A total of 1428 patients who underwent staged surgery for endometrial cancer at the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Anhui Medical University from January 2010 to January 2020 were collected,and a total of 1346 study subjects were included after reliable follow-up.SPSS 23.0 was used to analyze the study cohort with univariate and multifactorial models to explore the clinicopathological characteristics and importance associated with lymph node metastasis,ovarian metastasis,and poor prognosis.Results :1.Univariate analysis of lymph node metastasis showed that pathological type,cell differentiation grade,myometial infiltration,tumor diameter,cervical involvement,lymphovascular infiltration,preoperative CA125 and ovarian metastasis were significantly associated with lymph node metastasis in endometrial cancer（P<0.05）.Multi-factor logistic regression analysis showed that atypical pathological type,cervical invasion,positive LVSI,preoperative CA125 ≧ 35U/ml and ovarian involvement were independent predictors of lymph node metastasis（OR>1,P<0.05）.2.Univariate analysis of ovarian metastasis suggested that:deep myometrial infiltration（≧1/2）,primary tumor diameter,LVSI,preoperative CA125 and lymph node metastasis were strongly associated with the occurrence of ovarian metastasis（P<0.05）.Multi-factor logistic regression analysis suggested that only positive lymph nodes independently predicted the risk of ovarian metastasis（OR>1,P<0.05）.3.Univariate analysis of survival time suggested that pathological type,histological grade,depth of myometrial infiltration,cervical invasion,LVSI,lymph node metastasis,ovarian metastasis and postoperative adjuvant therapy were strongly associated with overall survival time（P<0.05）.Multi-factor Cox regression model and Kaplan-Meier survival curves showed that specific pathological type,cervical involvement,positive LVSI and lymph node metastasis were independent predictors of overall survival（HR>1,P<0.05）.Conclusions : 1.Specific pathological type,cervical involvement,positive LVSI,preoperative CA125 level and ovarian involvement have independent predictive value for lymph node metastasis in EC patients.The more concomitant risk factors,the higher the odds of lymph node metastasis in EC patients.2.Lymph node metastasis alone can be an independent prognostic factor for ovarian metastasis,and patients with lymph node metastasis should be highly alert to ovarian metastasis and cautiously preserve their ovaries.3.Specific pathological types,cervical invasion,positive LVSI and lymph node metastasis predict low survival rate and shorter survival time in EC patients.4.In clinical work,we assess patients’ risk of lymph node metastasis,ovarian metastasis and low survival rate by combining patients’ clinicopathological parameters to assist in the development of surgical plans and guide individualized treatment.