Microscopic ovarian metastasis of the uterine cervical cancer

Six hundred forty-seven cases of carcinoma of the uterine cervix with FIGO stages Ib or more were initially treated with hysterectomy at Kyushu University Hospital from 1973 to 1987. In these, 597 cases could be pathologically reviewed for ovarian metastasis. In these 597 cases, 335 were stage Ib, 71 IIa, 185 IIb, and 6 IIIb. Only 3 (0.5%) of 597 showed ovarian metastasis. All 3 cases were stage IIb. None of stage Ib cancer cases had ovarian metastasis. One (0.19%) of 524 squamous cell carcinomas metastasized to the ovary, whereas 2 (5.5%) of 36 pure adenocarcinomas revealed ovarian metastasis. Interestingly, all ovarian metastatic lesions were microscopic in size and found in the ovarian hilus. As for the primary lesion, all cases with ovarian metastasis showed deep myometrial invasion, corpus invasion, and lymphatic permeation. Two cases showed pelvic lymph node metastases and positive peritoneal washing cytology. From the results of our study, it can be said that it is fairly safe to preserve the ovary at the time of radical operation in squamous cell carcinoma of the uterine cervix, but it may not be safe to preserve the ovary in pure adenocarcinoma of the uterine cervix.     

Routes of lymphatic spread: a study of 112 consecutive patients with endometrial cancer

OBJECTIVE: The goal of this work was to assess different patterns of lymphatic spread to pelvic and para-aortic lymph nodes (LNs) in endometrial cancer as a function of the location of tumor within the uterus. METHODS: Between 1984 and 1999, 625 patients with endometrial cancer were managed with hysterectomy and node dissection at our institution. The present study includes the 112 (18%) patients who had positive pelvic and/or para-aortic LNs; 41 (37%) of them had cervical involvement. RESULTS: The external iliac was the most commonly involved pelvic LN site both in patients with tumor limited to the corpus and in those with cervical invasion. Isolated pelvic LN metastases to a single site were more frequently observed in external iliac LNs and obturator LNs in patients with tumor confined to the uterine corpus, whereas they occurred more commonly in external iliac and common iliac LNs in patients with cervical involvement. Metastasis to the common iliac LNs was more frequent in patients with disease extension to the cervix. In fact, common iliac LNs were positive in 67% of patients with cervical invasion, compared with only 30% of those with tumor confined to the uterine corpus (P < 0.01). Para-aortic LN invasion was significantly associated with obturator LN status. In fact, para-aortic LNs were positive in 64% of patients with positive obturator LNs compared with 23% of patients with negative obturator LNs (P = 0.01). All patients with positive para-aortic LNs and tumor invading the cervix had positive common iliac LNs. By contrast, when tumor was limited to the corpus, common iliac LNs were involved in only 27% of patients with positive para-aortic LNs. CONCLUSION: External iliac LNs are the most commonly involved LNs in endometrial cancer. Compared with carcinomas limited to the uterine corpus, endometrial cancers invading the cervix spread more readily to the common iliac LNs. Furthermore, these data suggest that para-aortic LN metastases spread via a route shared by the common iliac LNs when tumor involves the cervix but spread predominantly via a route common to the obturator LNs (and/or external iliac LNs) when the primary tumor site is the corpus only.     

Magnetic resonance imaging in stage I endometrial carcinoma

A prospective study was conducted on 50 consecutive patients with stage I endometrial cancer who had primary surgical treatment. The purpose of the study was to assess the value of magnetic resonance imaging (MRI) for accurate staging of early disease and determination of myometrial invasion. Features identified by MRI were correlated with surgical pathology. Preliminary MRI results provided additional valuable information. All but one of 18 patients with histologically proven deep myometrial invasion were predicted preoperatively by MRI. Of 17 patients with detached fragments of malignant tissue in the endocervical curettage (ECC) but with results inconclusive for actual cervical invasion, MRI revealed all three patients with true cervical tissue involvement. Magnetic resonance imaging detected all six patients with gross extrauterine spread and also precisely measured uterine enlargement by myomata. The extent and location of tumor growth in the uterus could be mapped out in the majority of cases. Based on these findings, a pretreatment MRI scan of the pelvis in presumably stage I endometrial carcinoma resulted in an advance in staging in 18% of the patients, and accurately predicted deep myometrial invasion in 94% of the cases. Inclusion of MRI in the routine work-up in stage I endometrial carcinoma should be considered for proper clinical staging, particularly in patients with a positive but nondiagnostic ECC, uterine papillary serous carcinoma, or grade 3 tumor.     

Squamous cell carcinoma antigen in cervical cancer.

Squamous cell carcinoma (SCC) antigen was described as being associated with malignant disease of the uterine cervix, and was determined by a radioimmunoassay technique. We studied squamous cell carcinoma serum levels in 72 patients from our gynecological clinic. Forty-three were diagnosed as having gynecological malignancies, and 29 as having benign diseases. The malignant disease group included 35 carcinomas of the uterine cervix, 7 endometrial cancers, and 3 vulvar cancers. Gynecological cancers were classified according to the FIGO system. We also determined SCC levels among 69 healthy subjects. Results showed that 97.1% of healthy subjects were below the cut-off point, 2.5 micrograms/l. Patients with benign gynecological diseases had increased SCC levels in 5.9% of cases. Among gynecological cancers, 56% of 23 cases of cervical cancer and one of three vulvar cancer, all of them in the active phase, had increased levels. The nine squamous carcinomas of the cervix with no evidence of disease, as well as seven endometrial adenocarcinomas with active disease were negative. Thirty-three percent of 12 cervical cancers in Stages I and II were high levels, compared to 81% of 11 advanced stages; none of the 2 early stage carcinoma of the vulva, but 1 advanced stage were increased. SCC is clinically applicable to monitor size and tumor volume of carcinomas of the uterine cervix derived from squamous epithelium.     

子宫峡部内膜癌的临床病理特征及预后

目的分析子宫峡部内膜癌的临床病理特点及预后相关因素。方法对天津医科大学总医院1980年1月至2005年12月收治的349例子宫内膜癌,按肿瘤部位分为峡部内膜癌（UIE）组与非峡部内膜癌组,比较两组临床病理特征及预后。结果UIE占10.0%（35/349）。与非峡部内膜癌相比,UIE组阴道排液及腹痛的比例较高（P〈0.05）。UIE组更容易发生深肌层浸润、宫颈侵犯、脉管浸润、浆膜受累、腹腔细胞学阳性以及盆/腹腔淋巴结转移,临床分期、手术病理分期较高（P均〈0.05）,具有较低的5年生存率（P〈0.05）。多因素分析显示峡部癌灶并非是预后不良的独立性相关因素。结论子宫峡部内膜癌具有特殊的临床病理特征,其可增强其他预后不良因素的作用而影响预后。     

Prognostic value of p53 expression in stage IB1 cervical carcinoma

The purpose of this retrospective study was to evaluate the patterns of p53 expression in stage IB1 squamous cell carcinoma of the uterine cervix, to compare p53 expression with clinicopathological findings, and to assess its prognostic value. 27 patients with stage IB1 squamous cell carcinoma of the uterine cervix underwent abdominal radical hysterectomy and pelvic lymph node dissection. Expression of p53 was studied immunohistochemically. Overexpression of p53 was detected in 33.3% of the tumors, low expression was seen in 11.1%, and negative expression was found in 55.6%. Deep cervical stromal invasion (> or = 1/2) was found to be associated with the increased risk of lymph node metastases (odds ratio = 17.5). A significantly lower percentage of patients survived when p53 overexpression was observed (p = 0.0315). Univariate analysis revealed that tumor size (2-3.9 cm), lymph node metastasis, tumor invasion into parametria, tumor invasion into blood/lymph vessels, squamous cell carcinoma antigen (> or = 2 ng/ml), and p53 overexpression had a significantly lower recurrence-free survival rate. None of these above factors obtained significance in the multivariate analysis. This study suggests that expression of p53 may be indicative of an unfavorable prognosis in patients with stage IB1 squamous cell carcinoma of the uterine cervix.     

Small cell carcinoma of the uterine cervix: overexpression of p53, BCL-2 and CD-44

Ten cases of small cell carcinoma of the uterine cervix are described. The mean age of the patients was 58 years. Seven patients had stage IB disease, two had IIA and one IIB. Eight patients died of disease (mean survival 1.7 years) and two are alive with widespread metastases. Most of the tumors were bulky masses (>4 cm) and 50% of them involved the entire cervical circumference. The depth of stromal invasion ranged from 50–100% with a mean of 65%.
Microscopically, all carcinomas show monotonous small to intermediate size cells arranged in irregular sheets. Focal glandular differentiation (less than 10%) was present in two, focal squamous differentiation in one. All tumors were positive for one or more neuroendocrine markers. Three patients with the shortest survival (mean 0.3 years) had p53 positive tumors. BCL-2 and/or CD-44 positivity was more common, detected in nine of 10 carcinomas. The only chemosensitive tumor had negative staining for all three markers. Overexpression of p53, BCL-2 and CD-44 in small cell carcinoma of the cervix may explain its poor response to treatment and may help to direct therapy in the future.     

The value of preoperative intracavitary radiation in uterine carcinoma

The analysis comprised 240 uterine carcinomas: 145 carcinomas of the cervix and 95 carcinomas of the corpus uteri. Preoperatively 100 patients--57 with the carcinoma of the cervix and 43 with the carcinoma of the uterine body--were radiated with Co60 intracavitary. In the first stage of the carcinoma of the cervix a five-year survival in primarily operated patients amounted to 74.30% and in the group of preoperatively intracavitary radiated patients to 83%. In patients with the stage I carcinoma of the corpus uteri a five-year survival proved to be 69.57% if primarily operated and 93.75% if preoperatively radiated. Local relapses were recorded in 33 patients surgically treated for carcinoma of the uterine cervix and in 9 patients surgically treated for the carcinoma of the uterine body. In both these localizations the relapses were more frequent in the group primarily operated patients: in patients with the primarily operated carcinoma of the cervix the relapses occurred in 20.69% and in preoperatively radiated patients in 3.4% of cases. The same observations were recorded in the carcinoma of the corpus uteri (11.51% : 6.97%). This means that the relapses were six times as frequent in patients with the primarily operated carcinoma of the uterine cervix and about 1.65 times as frequent in those with the primarily operated carcinoma of the corpus uteri as in intracavitary radiated patients.     

宫颈鳞癌临床分期和淋巴结转移高危因素分析

目的:分析宫颈鳞癌临床分期的准确性、淋巴结转移规律及与各临床病理因素的相关性,探讨淋巴结转移的高危因素及术前临床分期存在的问题和补充改进方法。方法:收集我院行根治性子宫切除+盆腔淋巴结清扫术508例临床ⅠA～ⅡB期宫颈鳞癌患者的临床病理资料,比较临床分期与手术-病理分期(pTNM)的结果,并分析临床病理因素与淋巴结转移之间的关系。结果:临床分期总的准确率为60.2%。单因素分析显示间质浸润深度、淋巴血管间隙浸润(LVSI)、临床分期、宫旁浸润、切缘浸润、阴道浸润、宫体浸润与淋巴结转移相关(P<0.05);多因素分析提示仅间质浸润深度、LVSI、临床分期与淋巴结转移相关(P<0.05)。结论:宫颈鳞癌临床分期的准确性欠佳,应用影像学检查(如MRI)等可能有助于提高分期准确率。间质浸润深度、LVSI、临床分期与淋巴结转移密切相关。     

Lymph node metastasis and lymph vascular space invasion in microinvasive squamous cell carcinoma of the uterine cervix

The objective of this study was to determine whether the depth of invasion was related to lymph vascular space invasion (LVSI) and lymph node metastasis and whether there was a correlation between LVSI and lymph node metastasis in stage IA cervical cancer. The medical records, including surgical notes and pathologic reports, of 202 patients with microinvasive squamous cell carcinoma of the uterine cervix were reviewed retrospectively. There was a positive correlation between the depth of invasion and the LVSI, and the incidence of lymph node metastasis was slightly higher than those reported hitherto for stage IA1 cervical cancer, especially in the depth of invasion of 1-3 mm group. However, among four patients with lymph node metastasis, only two patients had positive LVSI. There was no definite correlation between LVSI and lymph node metastasis. LVSI could not identify the patients with high risk for lymph node metastasis.     

The Significance of Peritoneal Cytology in Uterine Cervix and Endometrial Cancer

Objective.The purpose of this study was to determine the incidence of positive peritoneal cytology and to elucidate the prognostic value of peritoneal cytology in patients with uterine cervix and endometrial cancer.Materials and methods.The incidence of positive peritoneal cytology was investigated in 642 patients including 339 uterine cervix and 303 endometrial cancers. Survival was estimated by the Kaplan–Meier method in a subgroup of 116 stage II cervix and 199 stage I endometrial cancers, and multivariate analysis using Cox's proportional hazards model was used to identify an independent prognostic factor.Results.The incidence of positive peritoneal cytology was found to be 9% in uterine cervix cancer and 15% in endometrial cancer. The incidence was higher in patients with some clinicopathologic status such as advanced stage, lymph node metastasis, ovarian metastasis, and deeper myometrial invasion. The 5-year survival rate for patients with positive or negative peritoneal cytology was 44 or 80% in stage II cervix cancers and 80 or 92% in clinical stage I endometrial cancers, respectively. Multivariate analysis revealed that independent prognostic determinants were pelvic and paraaortic lymph node metastasis and peritoneal cytology in stage II cervix cancer and peritoneal cytology in stage I endometrial cancer. Proper treatment protocol should be scheduled for patients with positive peritoneal cytology.     

Stage IB adenocarcinoma of the cervix treated by radical hysterectomy and pelvic lymph node dissection

Fifty-five patients with Stage IB adenocarcinoma of the cervix were treated by radical hysterectomy and pelvic lymphadenectomy from 1965 through 1985. Bleeding was the presenting symptom in 56% of the patients. Twenty patients underwent cone biopsy for diagnostic purposes and 70% had residual carcinoma at the time of definitive surgery. A single postoperative death occurred as the result of pulmonary embolism. Tumor size, depth of invasion, and nodal metastases proved to be important prognostic factors. Tumor grade and histologic type were not related to tumor recurrence, although adenosquamous carcinoma was more frequently associated with a greater depth of invasion. Nine patients had nodal metastases, and 78% of patients with spread to the regional nodes developed recurrent carcinoma. Microscopic invasion beyond the cervix or metastases to lymph nodes was present in all but two of the 12 patients with recurrence after surgery. The overall recurrence rate was 22%, with 10 of 12 patients dead of disease, one patient alive with disease, and one patient without evidence of disease. Peritoneal cytologic studies were performed on 22 patients and all had negative cytologic findings. None of the patients with recurrent disease had evidence of intraperitoneal spread. Ninety-one percent of the patients had ovarian preservation, and there is no evidence that this contributed to tumor recurrence.     

Preoperative hysteroscopic assessment of cervical invasion by endometrial carcinoma: a retrospective study

OBJECTIVE: The aim of this study was to evaluate the efficacy of hysteroscopy, using normal saline (NS) or carbon dioxide (CO2) as the distention medium, in assessing tumor invasion of the uterine cervix by endometrial carcinoma. METHODS: A retrospective study was conducted in 200 consecutive patients with endometrial carcinoma diagnosed from 1993 to 2000. Prior to definitive surgical treatment, hysteroscopy was performed using either NS or CO2 as the distention medium to determine whether the tumor had spread to the cervix. The uterine specimens obtained after hysterectomies were cut open for gross examination. Tumor invasion of the cervix as determined by hysteroscopy and gross examinations was compared with the pathological findings. RESULTS: Tumor invasion of the cervix was found in 41 (20.5%) cases on pathological examination. Hysteroscopy has an accuracy of 92.5% (185/200), a sensitivity of 68.3% (28/41), and a specificity of 98.7% (157/159), with a PPV of 93.3% (28/30) and a NPV of 92.4% (157/170) in determining cervical involvement. Assessment by gross inspection had 93.0% (186/200) accuracy, 68.3% (28/41) sensitivity, 99.4% (158/159) specificity, 96.6% (28/29) PPV, and 92.4% (158/171) NPV. There was no significant difference between the two assessment methods. When the results of hysteroscopy performed with different distention mediums were compared, the use of NS had a higher accuracy in determining tumor spread to the cervix (96.8% vs 88.7%, P = 0.03) and NPV (96.4% vs 88.4%, P < 0.05) than the use of CO2. CONCLUSIONS: Hysteroscopic assessment and gross examination of the uterine specimen had similar efficacy in detecting cervical invasion by endometrial carcinoma. Hysteroscopic examination using NS is more accurate than that which uses CO2.     

Prognostic factors of adenocarcinoma of the uterine cervix

OBJECTIVE: The prognostic importance of adenocarcinoma of the uterine cervix was investigated. Methods. One hundred ninety-three patients (144 had stage I disease, 41 stage II, and 8 stage III-IV) with invasive adenocarcinoma of the uterine cervix treated initially at the Aichi Cancer Center between 1964 and 1995 were studied. RESULTS: Of all the invasive cervical cancers, 8.8% were adenocarcinomas that had been increasing during the past decade. The overall 5-year survival for stage I was 88.8%, stage II 44.9%, and stage III-IV 0% In univariate analysis, the clinicopathological factors associated with overall survival and disease-free survival were age of patient, stage of disease, presence of nodal metastasis, number of lymph nodes involved, lymph-vascular space invasion, tumor size, and intraperitoneal metastasis. Multivariate analysis performed in all cases identified the clinical stage of disease, the presence of nodal metastasis, number of lymph nodes involved, lymph-vascular space invasion, and tumor size as the independent risk factors for recurrence and survival. In the analysis of stage I disease, lymph node metastasis and tumor size were the significant prognostic factors, while lymph-vascular space invasion and tumor size were the factors in advanced disease. Tumor grade and histological type were not associated with recurrence and survival. CONCLUSION: These results suggested the association of lymph node metastasis with the prognosis of early stage adenocarcinoma of the uterine cervix and lymph-vascular space invasion with the advanced stage. Tumor size was an independent risk factor throughout all stages.     

Ovarian metastases are rare in stage I adenocarcinoma of the cervix

Over a 32-year period at the University of California, Los Angeles Medical Center, all cases of adenocarcinoma and adenosquamous carcinoma of the uterine cervix were reviewed to determine the incidence of ovarian metastases in stage I disease. One of 25 patients (4.0%) who underwent an exploratory laparotomy and radical hysterectomy had a microscopic ovarian metastasis. A literature review identified nine additional patients who had ovarian metastases and stage I adenocarcinoma of the cervix. Including our series, the overall reported rate of ovarian metastases is 1.8%. All ten patients had at least one of the following additional characteristics: They were postmenopausal, they had adnexal pathology, or they had positive pelvic lymph nodes. Thus, ovarian preservation is warranted in premenopausal patients who do not have ovarian pathology or evidence of other metastatic disease at surgery. Bilateral oophorectomy may be performed if frozen-section examination of enlarged or suspicious nodes documents metastases. If the ovaries are left in the pelvis at the completion of the surgical procedure and microscopic spread to other pelvic tissues is documented, pelvic irradiation can be administered.     

Lower uterine segment involvement as a predictor for lymph node spread in endometrial carcinoma

OBJECTIVES: Several predictive factors for lymph node spread in endometrial cancer have been identified including tumor grade, depth of invasion, lymphatic or vascular-space invasion, and histologic subtype. Lower uterine segment involvement may also be predictive of lymph node spread. The objective of this study was to investigate the relationship between lower uterine segment involvement in endometrial carcinoma and lymph node spread. METHODS: This was an IRB approved retrospective study. Data were collected for all patients diagnosed with endometrial cancer from June 1999 to December 2004. The primary end point was the presence of nodal involvement. Subset analysis was performed by histologic subtype. Univariate and multivariate nominal logistic regression was performed. Categorical variables were compared using Chi-square and Fischer's Exact Test. RESULTS: Two-hundred and ninety-nine subjects were eligible for review. One-hundred seventy four (58%) had lower uterine segment involvement. Forty-four (25%) of those with lower uterine segment involvement had positive nodes compared to 10 (8%) of those without (p=0.0001). On univariate analysis, lower uterine segment involvement, lymphovascular-space invasion, and deep invasion predicted nodal disease. On multivariate analysis, lower uterine segment remained predictive of nodal spread for the endometrioid subset. For high-risk histologies, only lymphovascular-space invasion and deep myometrial invasion were predictive of nodal spread. CONCLUSIONS: Lower uterine segment involvement in endometrial carcinoma is an important predictor of lymph node involvement for patients with endometrioid histologies. Tumor within the lower uterine segment may be an important factor to consider in intraoperative decision making regarding staging.     

Pretreatment lymphangiography in carcinoma of the uterine cervix

Pretreatment diagnosis of lymphatic involvement and evaluation of its extent are important in patients with carcinoma of the uterine cervix. From April 1973 to December 1974 all Stage I and II patients with histologically confirmed carcinoma of the cervix at Walter Reed Army Medical Center who were good operative risks underwent pretreatment lymphangiography. A total of 60 patients was studied. Clinical Stage I patients with negative nodes underwent Wertheim-Taussig hysterectomy. Stage II patients with negative lymphangiograms received radiation therapy. All patients with positive lymphangiograms underwent exploratory laparotomy providing histologic correlation and received appropriate postoperative radiotherapy.Histologic correlation with negative lymphangiograms was found in 94.1% of cases. All nodal metastases 1 cm or greater were identified radiologically, thus permitting a more rational selection of patients for surgical staging and enabling the precise direction of therapy.The results of this study suggest a definite role for lymphangiography as an adjunct in diagnosis and planning therapy in patients with carcinoma of the uterine cervix. It would appear especially useful in the selection of those patients who might benefit from removal of bulky metastases and extended field irradiation.     

Stromal invasion of the cervix can be excluded from the criteria for using adjuvant radiotherapy following radical surgery for patients with cervical cancer

BACKGROUND: Regarding complications of radiotherapy, the indications for adjuvant radiotherapy should be restricted. We conducted the present study to determine whether deep stromal invasion of the cervix could be excluded from the criteria used to identify patients for this treatment surgery. METHODS: This study included 115 patients with FIGO stage Ib to IIb cervical cancer who underwent radical hysterectomy and pelvic lymph node dissection. Patients had the following tumors: 61 nonkeratinizing squamous cell carcinoma, 21 keratinizing squamous cell carcinoma, 26 adenocarcinoma, and 7 adenosquamous cell carcinoma. Our study criteria for using adjuvant radiotherapy included positive lymph node involvement, a compromised surgical margin, or parametrial extension. Deep stromal invasion of the cervix was excluded from the criteria in this study. RESULTS: Seventy-two of the 115 patients (62.6%) underwent radical surgery only and all were alive. The remaining 43 patients received a complete course of external irradiation following radical surgery. The estimated 5-year survival rate is 100% for patients with stage Ib, 93.3% for stage IIa, and 52.7% for stage IIb. Fifty-five patients (47.8%) had deep stromal invasion. The prognosis for patients with deep stromal invasion was significantly worse than that for patients without deep stromal invasion (5-year survival rate, 69.8% vs. 98.0%). However, 21 patients (18.3%) with deep stromal invasion, but without positive lymph node involvement, compromised surgical margin, or parametrial extension, were alive without recurrence. Multivariate analysis showed that lymph node involvement and parametrial extension were independent prognostic factors, but that deep stromal invasion was not. CONCLUSION: Deep stromal invasion of the cervix can be excluded from the list of criteria for selecting patients with cervical cancer who would benefit from adjuvant radiotherapy following radical surgery.     

Ovarian metastasis in women with clinical stage I endometrial carcinoma

BACKGROUND: The incidence of ovarian metastasis in women with clinical stage I endometrial carcinoma is generally reported to be 5%, leading to the practice of removing the ovaries at surgery even in young patients. METHODS: A retrospective study of 84 patients with clinical stage I endometrial cancer was carried out. Patients were excluded if the pathologic study revealed any evidence of extrauterine, apart from adnexal, spread or if the peritoneal cytology was positive. Patients with serous papillary or clear cell tumor histology were also excluded. RESULTS: Sixty-seven patients fulfilled the inclusion criteria. Only three (4%) patients were found to be in surgical stage IIIA, all three had grade 3 tumors. Of these patients, two had uterine serosal involvement and one had a microscopic tumor implant in a fallopian tube; none had ovarian metastasis. CONCLUSIONS: The risk of ovarian metastasis in women with well to moderately differentiated endometrial cancer, myometrial invasion limited to less than one half of the myometrium, negative peritoneal cytology and no evidence of metastatic lymph node spread is negligible. Young patients with a preoperative histological diagnosis of well to moderately differentiated endometrial carcinoma may be surgically staged, leaving the final decision regarding removal of the ovaries pending a thorough pathological review of the surgical specimens.     

经阴道超声诊断子宫内膜癌

目的 探讨术前经阴道超声判断子宫内膜癌肌层浸润深度以及宫颈受累程度，为合理选择治疗方案提供科学依据的可能性。方法 术前应用经阴道超声对4l例子宫内膜癌患者进行了检查，测量子宫肌层浸润深度和观察宫颈受累程度。通过41例子宫内膜癌患者阴道超声影像分析，诊断肌层浸润程度及受累情况，与术后病理检查结果对照，分别计算其符合率与准确率。结果 33例绝经后子宫内膜癌患者内膜平均厚度20．54mm，41例子宫内膜癌超声影像均显示强弱不等，边缘不整，部分病例伴有不同程度的宫腔积液。与术后病理对照：超声诊断符合率97．76％，其中宫体受侵判断符合率95．12％（39／41），准确率70．73％（29／41），宫颈受累判断符合率82．93％（34／41），准确率78．05％（32／41）。结论 经阴道超声有助于子宫内膜癌术前治疗方案的合理选择。