胰岛素抵抗和代谢综合征与早期子宫内膜癌患者保留生育功能治疗后复发的关系OACSTPCD

Objective To investigate the relationship between insulin resistance(IR)and metabolic syndrome(MetS)and the recurrence of early endometrial cancer patients treated with fertility preservation therapy.Methods The clinical data of 111 pa-tients with early endometrial carcinoma who underwent fertility preservation therapy in No.910th Hospital of PLA Joint Service Support Force from January 2016 to December 2019 were retrospectively analyzed.The patients were divided into recurrent group(n=38)and non-recurrent group(n=73)according to whether they recurred within 3 years after treatment.COX risk ratio regression model was used to explore the factors that affected the recurrence of early endometrial cancer patients treated with fertility preservation therapy,and Kaplan-Meier method was used to analyze the relapse-free survival(RFS)characteristics of patients with different IR and MetS.Results BMI≥25 kg/m2(OR=2.723,95%CI:1.468-5.048,P=0.001),IR(OR=9.542,95%CI:1.468-5.048,P<0.001),MetS(OR=4.917,95%CI:2.610-9.260,P<0.001)and maintenance therapy(OR=0.381,95%CI:0.241-0.600,P<0.001)were independent risk factors for the recurrence in patients with early endometrial cancer after fertility preservation therapy.Kap-lan-Meier method showed that RFS of patients with IR was significantly worse than that of the patients without IR(χ2=14.329,P<0.001),and there was no significant difference in RFS between the patients with and without MetS(χ2=1.558,P=0.212).The RFS of IR+ and MetS+ group was significantly worse than that of IR and MetS group and IR+ or MetS+ group(χ2=24.436,P<0.001).Con-clusions Both IR and MetS are risk factors for the recurrence of early endometrial cancer in patients treated with fertility preservaion therapy,and they may play a synergistic role in its prognosis and recurrence.