Clinical Analyze Of Relative Prognostic Factors For Endometrial Carcinoma

[Objective]To explore the relative prognostic factors in endometrial carcinoma, analyze the effect of each factors and the correlation. To evaluate the prognostic value of serum CA125 and the superiority of combination serum CA125 with estrogen receptor and pregnant receptor in endometrial carcinoma. [Methods]Retrospective study was carried on 231 patients with endmetrial carcinoma treated in the General Hospital Of PLA from Jan. 1993 to Dec.2006. Analyzed retrospectively the clinico-pathological characteristics, therapies and 5-year overall survival rate. Evaluated the prognostic factors by univariate and multivariate analysis.And conducted x~2 test on the 120 patients who tested serum CA125 before surgery to find the correlation of serum CA125, ER and PR with pathological stage, histological type, pathological grade, depth of myometrial invasion and cervical invasion. [Results]The 1-year, 3-years, 5-years survival rate were 96.8%, 90.1%, 85.5% respectively. The univariate model revealed that clinical stage, cervical invasion, peritoneal cytology, pathological stage, histological type, pathological grade, depth of myometrial invasion, sex hormone receptor, lymph-vascular invasion, adnexa metastasis, lymph node resection and the use of adjuvant treatment after operation significantly associated with prognosis. On multivariate regression analysis, pathological stage, cervical invasion, pathological grade, histological type, depth of myometrial invasion are independent prognostic factors.The value area of serum CA125 is 0～864U/ml, median is 22.26U/ml. Thedifference of serum CA125 positive rate in pathological stage, depth of myometrial invasion and cervical invasion were significant (P<0.05), but the expression of CA125 positive rate in histological type, pathological grade had no statistical difference (P>0.05). ER negative rate was related to pathological stage(P < 0.05) and PR negative rate was related to pathological stage and pathological grade (P<0.05). The values of combination were higher than those in single (P<0.05) .[Conclusion]Pathological stage, cervical invasion, pathological grade, histological type, depth of myometrial invasion are independent prognostic factors in endometrial carcinoma. Comparing with clinical stage, pathological stage could assess prognosis more objectively. Deep myometrial invasion is the strongest predictor of hematogenous dissemination; and cervical invasion increases the rate of lymph node metastasis. In order to improved the prognosis, individual therapies should be taken. Perfect operation project and proper adjuvant treatment are important.Serum CA125 is valuable in predicting the width of tumor offended and may be helpful in estimating the metastasis. The method of combinative detection index is better in predict the prognosis.