| ObjectiveTo explore the clinicopathological characteristics and prognostic factors of uterine sarcoma,and provide reference for the early diagnosis and standardized treatment of uterine sarcoma.MethodsFrom January 2010 to December 2019,80 cases of uterine sarcoma were treated in Dalian Women and Children’s Medical Group Chunliu Hospital.The general clinical data of all patients were retrospectively analyzed and followed up.There were 40 cases of leiomyosarcoma and 40 cases of endometrial stromal sarcoma.The follow-up time is up to December 2022,and the follow-up time is more than 3 years.5 cases were lost to follow up,and those who lost to follow up were treated as dead.The general clinical data of all patients were analyzed retrospectively,including age,times of pregnancy and childbirth,menopause,clinical manifestation,imaging examination,serological examination,surgical type,adjuvant treatment,postoperative pathological type(immunohistochemistry),etc.SPSS25.0 statistical software was used to carry out single factor and multiple factor analysis on the above data,in which the counting data was expressed by frequency(percentage),the measurement data by t-test,and the grade data by rank sum test.Chi-square test was used to compare the single factor of different clinical characteristics,the number of cases was less than 40,Fisher’s exact probability method was used to test,and Cox proportional risk model was used for multifactor analysis,P<0.05 indicated that the difference was statistically significant.Results1.The average age of the 80 patients was 45.93 years old,the youngest was 27 years old,and the oldest was 71 years old.The average age of leiomyosarcoma was(47.55 ± 7.07)years old,and the average age of endometrial stromal sarcoma was(44.36 ± 9.80)years old.In patients with stage II,the average age of leiomyosarcoma was larger than that of endometrial stromal sarcoma(P=0.009),and the difference was statistically significant(P<0.05).2.Among CA125 positive patients,menopausal patients(P=0.049)and patients with tumor>5cm(P=0.028)had poor survival results,and the difference was statistically significant(P<0.05).3.In the two pathological types,the expression of P53 in the wild type was more than that in the mutant type(P=0.001),and the difference was statistically significant(P<0.05).The positive expression of progesterone receptor(PR)in endometrial stromal sarcoma was stronger than that in uterine leiomyosarcoma(P=0.037),4.There were more lymph node metastasis in endometrial stromal sarcoma than in leiomyosarcoma(P=0.029).Among endometrial stromal sarcomas,postmenopausal patients(P=0.003),those with higher tumor stage(P=0.026)and those with tumor>5cm had poorer survival results(P=0.007).The difference between the above results was statistically significant(P<0.05).5.Among the patients with uterine leiomyosarcoma,menopause(P=0.025),lymph node resection(P=0.049),high tumor stage(P=0.000),tumor>5cm(P=0.012),Ki-67expression>10%(P=0.012)and PR expression positive(P=0.007)had poor survival results,and the difference between the above results was statistically significant(P<0.05).6.Tumor stage and tumor size are two independent prognostic factors for uterine leiomyosarcoma.Menopause is an independent prognostic factor for endometrial stromal sarcoma.ConclusionUterine sarcomas tend to occur in middle-aged women.The average age of onset of uterine leiomyosarcoma in stage II patients is larger than that of endometrial stromal sarcoma.In uterine leiomyosarcoma,the higher the menopause,lymph node resection,tumor stage,tumor size,Ki-67 and PR expression,the prognosis is worser.In endometrial stromal sarcoma,the expression of PR is stronger than that of leiomyosarcoma.In endometrial stromal sarcoma,menopause,high tumor stage,larger tumor size and poorer prognosis are the main factors.The expression of P53 in wild type was more than that in mutant type.Among CA125 positive patients,menopausal patients and those with tumors larger than 5cm had poor survival results. |
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