子宫内膜癌肌层浸润深度的评估

目的　探讨术前B超、术中肉眼观察、术后大体标本测量和血清CA12 5测定 ,对判断子宫内膜癌肌层浸润深度的价值。方法　采用术前B超、术中肉眼观察和术后大体标本测量对 13 3例手术病理分期Ⅰ期子宫内膜癌患者的肌层浸润深度的判断进行评估 ,并分析 91例 (79例为Ⅰ期 ,12例为同期的Ⅱ～Ⅳ期患者 )子宫内膜癌患者血清CA12 5水平与子宫内膜癌的关系。结果　术前B超判断子宫内膜癌肌层浸润和深肌层浸润的敏感性分别为 62 6%和 47 8% ,特异性分别为 67 7%和90 0 % ;术中肉眼观察判断子宫内膜癌肌层浸润和深肌层浸润的敏感性分别为 5 9 6%和 73 9% ,特异性分别为 76 5 %和 94 6% ;术后大体标本测量判断子宫内膜癌肌层浸润和深肌层浸润的敏感性分别为 70 0 %和 94 4% ,特异性分别 92 0 %和 97 7%。子宫内膜癌手术病理分期Ⅰ期患者血清CA12 5水平异常 (≥ 3 5kU/L)的发生率为 8% (6/79) ,Ⅱ～Ⅳ期患者的发生率为 5 8% (7/12 ) ,血清CA12 5水平异常的发生率与手术病理分期的期别有极显著相关性 (P <0 0 0 1) ,而与子宫内膜癌肌层浸润深度无显著相关性 (P >0 0 5 )。结论　术前B超、术中肉眼观察和术后大体标本测量对判断Ⅰ期子宫内膜癌肌层浸润深度有一定帮助 ,其中术后大体标本测量的准确性相对较好。血

Evaluation of myometrial invasion in endometrial carcinoma

Objective To determine the value of preoperative ultrasound, intraoperative gross visual inspection and postoperative bulk specimen measurement in evaluating the diagnosis of myometrial invasion in endometrial carcinoma Methods A total of 133 cases of women with endometrial carcinoma were analyzed focusing on evaluating the diagnosis of myometrial invasion by preoperative ultrasound, intraoperative gross visual inspection and postoperative bulk specimen measurement The relationship between CA 125 and endometrial carcinoma of 91 cases of endometrial carcinoma was also analyzed Results In the diagnosis of myometrial invasion and deep myometrial invasion, ultrasound showed a sensitivity of 62 6% and 47 8% and a specificity of 67 7% and 90 0%, respectively, and intraoperative gross visual inspection showed a sensitivity of 59 6% and 73 9% and a specificity of 76 5% and 94 6%, respectively The sensitivity of postoperative bulk specimen measurement was 70 0% and 94 4% and the specificity was 92 0% and 97 7%, respectively The levels of CA 125 had no correlation with depth of myometrial invasion in endometrial carcinoma, but they had correlation with Internationale Feberation of Gynecology and Obstetrics (FIGO) stage Conclusions Preoperative ultrasound, intraoperative gross visual inspection and postoperative bulk specimen measurement were helpful to the diagnosis of depth of myometrial invasion in endometrial carcinoma, and postoperative bulk specimen measurement seems to be better CA 125 could not evaluate depth of myometrial invasion in endometrial carcinoma