Aclinical Analysis On Coexisting Ovarian Malignancy In 50 Patients With Endometrial Carcinoma

Objective Our objective was to analyze the clinical pathology and characteristics for ovarian metastasis and to evaluate the feasibility of ovarian preservation in patients with endometrial carcinoma and to compare the synchronous primary carcinomas of the endometrium and ovary with endometrial cancer with ovarian metastasis by analysising the clinical pathology and characteristics.Methods the pathological and clinical features of 788 endometrial carcinoma patients including 41 metastatics and 9 synchronous primary endometrial and ovarian carcinomas who were diagnosed and treated in our hospital from jan 1985 to jan 2016 were restrospectively reviewed and analyzed,and there are 21 microscopic ovarian metastasis among the 41 metastatics.all of the patients’ initial treatment was surgical treatment.Datas were analyzed by SPSS 19.0 software packet,this study used logistic regression analysis on age,menopause,histological type and grade,cervical invasion,parametrial infiltration,depth of myometrial invasion,pelvic lymph node metastasis,ascites or peritoneal lavage cytology,tubal metastasis,invasion of uterine serosa,tumor diameter,para-aortic lymph node metastasis,the serum of CA125≥35U/m L,the serum of HE4≥73pmol/l,and the family history of cancer.And the difference between metastatics and the synchronous primary carcinomas of the endometrium and ovary is analysed by Chi-square test,if the number of two groups was more than 40 members,we accepted the four tables of x2 test results.When the number of two groups was less than 40,we got the the calculation results by Fisher’s exactprobability method.Measurement data using T test between the two groups.Inspectionlevel of alpha = 0.05.Results(1)Univariate analysis revealed that histological type and grade,depth of myometrial invasion,parametrial infiltration,tubal metastasis,pelvic lymph node metastasis,cervical infiltration,the serum of CA125≥35U/m L and invasion of uterine serosa were significantly associated with ovarian metastasis(p<0.05).While age,tumor diameter,para-aortic lymph node metastasis,the peritoneal fluid cytology,the serum of the HE4≥73 pmol/l,the family history of cancer and preoperative clinical staging were not significantly associated with ovarian metastasis(p>0.05).Factors predictive of ovarian metastasis on logistic regression were tubal metastasis,parametrial infiltration and the serum of CA125≥35U/m L(p<0.05).(2)There were statistical significance among histological grade and the size of the ovarian tumor between the metastatics and the synchronous primary endometrial and ovarian carcinomas(P < 0.05).(3)Univariate analysis revealed that histological type and grade,depth of myometrial invasion,parametrial infiltration,tubal metastasis,pelvic lymph node metastasis,the serum of CA125≥35U/m L and ascites or peritoneal lavage cytology positive were significantly associated with microscopic ovarian metastasis(p<0.05),while our research doesn’t find any factor significantly associated with microscopic ovarian metastasis on mutiple logistic regression.Conclutions : 1.tubal metastasis,parametrial infiltration and the serum of CA125≥35U/m L are the predictive factors for ovarian metastasis of endometrial carcinoma.2.histological type and grade,depth of myometrial invasion,parametrial infiltration,tubal metastasis,pelvic lymph node metastasis,the serum of CA125≥35U/m L and ascites or peritoneal lavage cytology positive were significantly associated with microscopic ovarian metastasis(p<0.05).3.Compare with primary endometrial cancer with ovarian metastasis,patients with the synchronous primary carcinomas of the endometrium and ovary patients have lower histological grade and larger ovarian size.