Correlation of Abnormal Glucose Metabolism with Clinicopathology and Prognosis of Stage I Endometrioid Adenocarcinoma
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0609
- VernacularTitle:糖代谢异常与Ⅰ期子宫内膜样腺癌临床病理及预后的相关性
- Author:
Chang-hao LIU
1
;
Hai-xue LIN
1
;
Miao-fang WU
1
;
Jing LI
1
;
Li-juan WANG
1
Author Information
1. Department of Gynecological Oncology， Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University， Guangzhou 510120， China
- Publication Type:Journal Article
- Keywords:
endometrioid adenocarcinoma （EA）;
abnormal glucose metabolism;
insulin resistance;
survival;
recurrence
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(6):883-891
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the correlation of different types of abnormal glucose metabolism with the clinicopathological features and prognosis of stage I endometrioid adenocarcinoma （EA）. MethodsA total of 387 patients with stage I endometrioid adenocarcinoma who underwent surgical treatment at the Department of Gynecological Oncology， Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2015 to December 2019 were divided into impaired glucose metabolism （IGM） group and normal glucose tolerance （NGT） group. IGM group was further subdivided into diabetes mellitus （DM） group， impaired glucose tolerance （IGT） group and impaired fasting blood glucose （IFG） group. We retrospectively analyzed the clinicopathological indicators and prognosis of each group， and explored the effects of IGM on the prognosis of stage I EA and the related factors affecting the prognosis. ResultsBoth 5-year cumulative survival rate and progression free survival （PSF） rate in IGM group were significantly lower than those in the NGT group（P<0.05）. In DM group， those with glycosylated hemoglobin 1c （HbA1c）≥7.0% had lower 5-year cumulative survival rate and PFS rate than those with HbA1c＜7.0% （P<0.05）. Multivariate COX regression analysis revealed that CA125 level （≥35 U/mL） and lymphovascular space invasion （LVSI）-positive were independent risk factors for 5-year cumulative survival rate. LVSI-positive， impaired lipid metabolism and deep myometrial invasion were independent risk factors for 5-year cumulative PFS rate. ConclusionIn patients with stage I EA， those with IGM have poorer prognosis than those with NGT. Good control of blood glucose levels may improve the prognosis of EA patients with comorbid DM in early stage. Prognostic factors for stage I EA include CA125 level （≥35 U/mL）， LVSI-positive， impaired lipid metabolism and deep myometrial invasion.
