Clinical Analysis Of 58 Cases Of Uterine Sarcoma

Objective To analyze the general data(including age,menarche age,menopause,clinical manifestations,past history,reproductive history,blood type,tumor marker CA12-5and imaging examination)of patients with uterine sarcoma and different subtypes of uterine sarcoma,surgical methods,immunohistochemistry,survival analysis and prognostic factors.To provide reference for the diagnosis and treatment of uterine sarcoma.Methods A retrospective analysis was made of the medical records of 58 patients with uterine sarcoma admitted to Ningxia Medical University General Hospital from January 2011to December 2017 and confirmed by pathology after operation.Statistical software used SPSS 22.0 for data analysis,t-test for measurement data,?~2 test for counting data,prognostic factor analysis in single factor analysis using Kaplan-Meier survival curve method,Log-rank logarithmic test,multivariate analysis using COX regression.The difference was statistically significant with P<0.05.Results 1.There were 58 patients with uterine sarcoma(US),aged from 26 to 72 years,with an average age of 47.45±10.22 years and a median age of 48 years.Among them,there were 28 patients with endometrial stromal sarcoma(ESS),with an average age of 42.21±9.61years and a median age of 42 years.There were 18 patients with uterine leiomyosarcoma(uLMS)with an average age of 50.22±8.74 years and a median age of 50 years.There were11 patients with uterine carcinosarcoma(CS),with an average age of 55±6.66 years and a median age of 53 years.One patient with uterine undifferentiated sarcoma(UUS),aged 61years,was not included in the statistical analysis.The average age of ESS was younger than that of uLMS and CS patients,and the difference was statistically significant(P=0.007,P=0.000).The median age of 48 was divided into two groups.There were significant differences in the age of ESS,uLMS and CS(P=0.001).2.The most common clinical manifestation of US is vaginal abnormal bleeding,accounting for 62.1%,especially postmenopausal vaginal bleeding,accounting for 84.2%(16/19),followed by lower abdominal discomfort accounting for 39.7%.3.There was no significant difference in menarche age,body mass index,presence or absence of childbirth,multiple delivery,blood type,CA12-5 and FIGO stages among different subtypes of uterine sarcoma.However,there was significant difference in the performance of different subtypes of uterine sarcoma between menopause and nonmenopause(P=0.000).4.Of the 58 patients with US,13 underwent curettage before operation.The pathology showed 12 cases of malignant tumors,accounting for 93.31%(12/13).One case showed uterine leiomyoma.10 patients were CS patients,accounting for 76.9%(10/13).One of the 58 patients with US had no surgical treatment(CS patients),and the rest were treated with surgery.16 cases of secondary surgery,accounting for 28.1%.5.In this study,five immune-histochemical markers(ER,PR,CD10,Desmin,SMA)were analyzed.There was no difference in the distribution of ER among different subtypes of uterine sarcoma(P=0.415),while the distribution of PR,CD10,Desmin and SMA had statistical significance,with P values of 0.044/0.000/0.000/0.007,respectively.6.The 1-,2-and 5-year survival rates of 58patients with US were 93%,85.5%and 76.4%respectively.7.According to age,menop-ausal status,pathological stage,histological type,lymph node dissection,ovarian presser-vation and adjuvant treatment after operation,univariate analysis was conducted in US patients.Age,menopausal status,pathological stage and histological type affected the pro-gnosis of US patients.The P value was 0.039/0.013/0.02/0.009,respectively.Age,meno-pausal status,FIGO stage and histological type were included in COX model.Multivariate analysis showed that FIGO stage was an independent factor affecting the prognosis of US[P=0.022,HR=4.071,HR(95%CI)1.225-13.525].Conclusion 1.Uterine sarcoma is predisposed to perimenopause.The clinical manifest-tations of uterine sarcoma are mainly abnormal vaginal bleeding.2.Patient age,menopause,FIGO stage and different pathological types are risk factors for prognosis of patients with uterine sarcoma.FIGO stage is an independent factor affecting the prognosis of patients.