Accuracy of preoperative tumor grading and intraoperative gross examination of myometrial invasion in clinical stage Ⅰ endometriod adenocarcinoma
10.3760/cma.j.issn.0529-567x.2009.07.010
- VernacularTitle:术前诊刮后病理分级和术中肉眼判断肌层浸润深度预测临床Ⅰ期子宫内膜样腺癌高危因素的准确性评价
- Author:
Xinyu WANG
;
Zimin PAN
;
Xing XIE
- Publication Type:Journal Article
- Keywords:
Endometrial neoplasms;
Carcinoma,endometrioid;
Neoplasms staging;
Neoplasm invasiveness;
Lymph node excision;
Risk factors
- From:
Chinese Journal of Obstetrics and Gynecology
2009;44(7):518-521
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate accuracy of preoperative tumor grade and intracperative gross examination of myometrial invasion in patients with clinical stage Ⅰ endometriod adenocarcinoma for lymphadenectomy. Methods Clinic-pathological data were retrospectively collected from 687 patients with clinical stage Ⅰ endometriod adenocarcinoma who underwent operation in Women's Hospital, Zhejiang University School of Medicine from January 1999 to December 2008. According to postoperative histology diagnosis, accuracy of preoperative tumor grade by curettage and depth of myometrial invasion by intraoperative gross examination was evaluated, and clinic-pathological factors associated with accuracy were analyzed. Results Sensitivity, specificity, accuracy, false negative rate, false positive rate, and positive and negative predictive value for the prediction of needing for intraoperative lymphadenectomy in patients with clinical stage Ⅰ endometriod adenocarcinoma were 70. 4% ,80. 2% ,77.6% ,12.0%, 43.0%, 57.0% and 88.0%, respectively. Analysis of mutil-factors shown that patient age, tumor size, lymph node metastasis and extrauterine spread lesions were independent factors affected the accuracy of prediction(P ＜ 0. 05 ). Conclusion Prediction of needing for lymphadenectomy by preoperative tumor grade and intraoperative gross examination of myometrial invasion is reliable in clinical stage Ⅰ endometriod adenocarcinoma patients, while there is a highly false negative rate in prediction of not needing for lymphadenectomy, while other prognostic factors such as patient age, tumor size, lymph node metastasis and extrauterine spread lesion should be together considered.
