Endometrium kanserinde lenfovasküler saha i̇nvazyonu ile kötü prognostik faktörlerinin i̇lişkisinin i̇ncelenmesi

Öz

Amaç: Bu çalışmada endometrium kanserinde (EK) lenfovasküler saha invazyonu varlığının (LVSİ) tümör differansiasyon düzeyi (grade), miyometrial invazyon, lenf nodu metastazı ve tümör evresi gibi kötü prognostik faktörler ile ilişkisinin incelenmesi amaçlanmıştır. Gereç ve yöntem: Kliniğimizde EK nedeniyle total histerektomi + bilateral salpingooferektomi ± pelvik ve/veya paraaortik lenfadenektomi + omentektomi yapılmış 44 hasta retrospektif olarak incelenmiştir. Patoloji sonuçlarına göre hastalar LVSİ pozitif ve negatif olmak üzere 2 gruba ayrılmıştır. LVSİ olmayan 29 hasta ile kontrol grubu ve LVSİ pozitif olan 15 hasta ile çalışma grubu oluşturulmuştur. Bulgular: Çalışma grubunda istatistiksel olarak kontrol grubuna göre ana materyal nükleer grade daha yüksek bulunmuştur (p=0.001 ve p<0.05). Miyometrial invazyon varlığı açısından her iki grup arasında istatistiksel olarak anlamlı farklılık bulunamamış (p=0.999 ve p<0.05) olmasına rağmen LVSİ pozitif olan çalışma grubunda miyometrial invazyon derinliğinin istatistiksel olarak anlamlı şekilde daha fazla olduğu tespit edilmiştir (p=0.001 ve p<0.05). LVSİ pozitif olan grupta istatistiksel olarak anlamlı olacak şekilde pelvik lenf nodu tutulumu daha fazladır (sağ pelvik lenf nodu için p=0,003 ve p<0,005; sol pelvik lenf nodu için p=0.001 ve p<0.05). LVSİ pozitif olan grupta istatistiksel olarak anlamlı şekilde daha ileri evre hastalık bulunmuştur (p=0.009 ve p<0.05). Sonuç: EK’de LVSİ varlığında yüksek gradeli tümör, derin myometrial invazyon, artmış lenf nodu tutulumu ve daha ileri evre hastalık tespit edilmektedir.

Anahtar Kelimeler

• Endometrial Kanser
• Lenfovasküler Saha Invazyonu
• Prognostik Faktörler

The investigation of poor prognostic factors related to lymphovascular space invasion in endometrium cancer

Öz

Aim: It was aimed to investigate the relationship between the presence of lymphovascular space invasion (LVSI) in endometrial cancer (EC) and poor prognostic factors such as tumoral grade, myometrial invasion, lymph node metastasis and stage of the disease in this study. Materiasl and methods: Forty-four patients who underwent total hysterectomy + bilateral salpingoophorectomy ± pelvic and/or paraaortic lymphadenectomy + omentectomy for EC in our clinic were retrospectively analyzed. According to the pathology results, the patients were divided into 2 groups as LVSI positive and negative. A control group with 29 patients without LVSI and a study group with 15 patients with positive LVSI were conducted. Results: A statistically significant difference was found between two groups in terms of nuclear grade (p=0.001 and p<0.05). Although there was no statistically significant difference between the two groups in terms of the presence of myometrial invasion (p=0.999 and p<0.05), the depth of myometrial invasion was found to be significantly deeper in the study group (p=0.001 and p<0.05). Statistically significant differences were found in the group with positive LVSI in terms of right (p=0.003 and p<0.005) and left (p=0.001 and p<0.05) pelvic lymph node involvement. When both groups were compared in terms of main material surgical staging, we found that the LVSI positive group had more advanced stage disease (p=0.009 and p<0.05). Conclusion: High-grade tumor, deep myometrial invasion, increased lymph node involvement and more advanced disease are detected in the presence of LVSI in EC.

Anahtar Kelimeler

• Endometrial Cancer
• Lymphovascular Site Invasion
• Prognostic Factors

Kaynakça

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