子宫平滑肌肉瘤发生远处转移的相关危险因素

Risk Factors for Metastasis with Uterine Leiomyosarcoma

摘要: 目的：探讨子宫平滑肌肉瘤发生远处转移的相关危险因素。方法：本研究利用美国国立研究所监测、流行病学和最终结果(The Surveillance, Epidemiology, and End Results, SEER)，回顾性分析2010~2015年由组织学确诊的子宫平滑肌肉瘤(uterine leiomyosarcoma, ULM)患者的人口学及临床病理特征。采用单因素和多因素logistic回归分析来确定与远处转移相关的危险因素。同时，采用Kaplan-Meier生存曲线分析不同转移部位的预后。结果：从SEER数据库中共收集1521例原发性ULM患者。445例(29.3%)患者初诊时存在远处转移。其中，年龄较大、肿瘤直径较大、肿瘤组织病理学分级III级及黑种人发生远处转移的风险较高。常见的转移部位为肺，其次是肝和骨。Kaplan-Meier绘制生存曲线分析结果提示仅肺转移与两个或两个以上部位转移两组之间无统计学差异。结论：年龄较大、肿瘤体积较大、肿瘤病理III级或黑种人患者发生转移的可能性较高，需早警惕、早诊断、早治疗。

Abstract: Aim: To identify risk factors of metastasis at initial diagnosis in uterine leiomyosarcoma patients. Methods: We collected uLMS patients from the Surveillance, Epidemiology and End Results database between 2010 and 2015, using the SEER*Stat software (version 8.3.5). The following data were collected for each included patient: age, race, marital status, tumor size and tumor pathological grade. Univariate and multivariate logistic regression analysis were utilized to determine risk factors associated to metastasis. Meanwhile, different metastatic sites were analyzed using the Kaplan-Meier method. Results: A total of 1521 primary uLMS patients diagnosed from 2010 to 2015 were collected from the SEER database. And distant metastasis was present in 445 (or 29.3%) of the patients at diagnosis. Patients with older ages, a larger tumor size, tumor pathological grade III or black patients had a higher risk of metastasis. Besides, the common metastatic site was lung, followed by liver and bone. The survival analysis had no statistically significant differences between lung metastasis alone and two or more metastatic sites. Conclusion: uLMS patients with older ages, a larger tumor size, tumor pathological grade III or black patients were associated with higher possibility of metastasis, requiring early vigilance, early diagnosis and early treatment.