Clinical, Pathologic Features And Prognosis Of The Endometrial Carcinoma Combined With Adenomyosis

Objective: Through the respectively analysis of the clinical and pathological characteristics and prognosis outcome of 1584 endometrial carcinoma patients with or without adenomyosis,to investigate whether there are some unique features about pathology and prognosis in the endometrial carcinoma associated with adenomyosis and know whether the adenomyosis maybe a factor on the survival outcome of the patients with endometrial carcinoma.Methods:The clinical and pathologic factors and survival outcomes of 1584 patients with endometrial carcinoma who were underwent primary surgical treatment and confirmed by pathology from Jan 2008 to Dec 2014 in the Fourth Hospital of Hebei Medical University were studied.We built an excel databases with clinicopathologic factors and follow-up outcomes and analyzed the features about pathology and prognosis.SPSS 16.0 software package was used.We used Kaplan-Meier method to caculate the survival rates and draw the survival curve,and the comparison between the survival rates was estimated by log-rank test.Multiple regression analysis was estimated by Cox proportional hazards modle.Measurement data were compared with non-parametric test.Enumeration data were compared with χ2 test.A statistically significant difference was indicated by P<0.05.Results:1 There were 150(9.47%)endometrial cancer patients with adenomysis in the collected 1584 endometrial cancer patients.These patients with adenomyosis were relatively younger than the control patients(53 versus 55);2 Among the endometrial cancer cohort,adenomyosis was assiociated with earlier stage,lower grade,lower likelyhood of deep myometrial invasion and pelvic lymph node metastasis than those without adenomyosis.There was no statistically significant difference in cervical,adnexa invasion or LVSI.Although aortic lymph node metastasis was more common in the non-adenomyosis group(n=35,4.36%)than in cases with adenomyosis(n=0),the difference couldn’t be calculated;3 The adenomyosis was assosiated with the lower positive rate of p53(53.39% versus 63.32%).There was no statistically significant difference in positive rate of ER,PR,Ki-67,survivn or CA125;4 The overall 5-year survival rate of endometrial carcinoma was 85.5%,and 113 patients were died of endometrial carcinoma;5 Endometrial carcinoma coexisting with adenomyosis was associated with a significantly better survival(5-year rate,92.1% vs 84.1%,P=0.045);6 In multivariate analysis,presence of adenomyosis was not an independent prognostic factor.Conclusions:Adenomyosis appears to be associated with earlier stage,lower grade,lower likelyhood of deep myometrial invasion and pelvic lymph node metastasis than those without adenomyosis.Endometrial carcinoma coexisting with adenomyosis was associated with a significantly better survival.However,in multivariate analysis,presence of adenomyosis was not an independent prognostic factor.