Diagnostic Value Of Hysteroscopy In Endometrial Cancer

Objective:There is currently no effective screening method for endometrial cancer.Once the preoperative staging is confirmed,the patient’s surgical treatment plan and prognosis are directly related.By retrospective analysis,this study evaluated the value of hysteroscopic techniques in the diagnosis of endometrial cancer and analysised the relevant clinical factors.Aiming to provide a reference for choosing the best diagnostic method and optimizing the patient’s surgical plan.Methods:A total of 3,730 cases of endometrial cancer or it’s precancerous lesions were diagnosed from the Fourth Hospital of Hebei Medical University from January 1,2013 to October 30,2018.A total of 677 cases of endometrial cancer diagnosed by endoscopic tissue obtained by hysteroscopy or electrotomy were screened.Detailed review of patient clinical data and establishment of an Excel database.Measurement data are expressed in mean +/-standard deviation and percentile.One-way analysis was performed by chi-square test between the two groups,P<0.05 was statistically significant.Results:1.677 patients with endometrial cancer undergoing hysteroscopy + segmental diagnosis of 452 cases(452/677,66.8%),Among them,30 cases were diagnosed as endometrial atypical hyperplasia,the rate of missed diagnosis was 6.6%,and 225 cases(225/677,33.2%)were diagnosed by hysteroscopic resection.Among them,14 cases were diagnosed as endometrial atypical hyperplasia.The rate of missed diagnosis was 6.2%.There was no difference in the rate of missed diagnosis between hysteroscopic resection and hysteroscopy(P>0.05).2.Diagnosis of deep muscle infiltration,sensitivity: intraoperative findings>magnetic resonance imaging,specificity: magnetic resonance imaging> intraoperative findings;diagnosis of cervical invasion,sensitivity: magnetic resonance imaging> hysteroscopy> intraoperative findings,Specificity is entire greater than 99.0%;diagnosis of lesion size,sensitivity: hysteroscopy>intraoperative findings,specificity: intraoperative findings> hysteroscopy;diagnosis of lymph node metastasis,sensitivity: magnetic resonance imaging>intraoperative findings,specificity: Intraoperative findings>magnetic resonance imaging.Hysteroscopy is not used for the diagnosis of deep muscle invasion and lymph node metastasis.In the magnetic resonance imaging the return on the size of the lesion is too small to be analyzed.3.Only 76 cases(76/677,11.2%)of pathological diagnosis before surgery suggested the classification of tumors,including 59 cases of poorly differentiated cancer,accounting for 77.6% of the total number of the reportd cases,and 41 cases of poorly differentiated cancer in the 59 cases.The diagnostic accuracy was 69.5%(41/59).4.Intrauterine occupying with blood flow signal or endometrial thickening with uneven texture is common B-ultrasound manifestation in patients with endometrial cancer;postmenopausal vaginal bleeding,irregular vaginal bleeding,abnormal vaginal discharge is common in patients with endometrial cancer Clinical manifestations.5.Age>50 years old,overweight,postmenopausal vaginal bleeding with hypertension and / or diabetes is a high risk factor for endometrial cancer,carbohydrate antigen 125 is not sensitive in early diagnosis.Conclusion:Hysteroscopy + segmental curettage and hysteroscopic resection are both effective methods for diagnosing endometrial cancer.The diagnostic accuracy of the two shows no difference in this study.Hysteroscopy,magnetic resonance imaging and intraoperative uterine dissection have their own advantages in diagnosis.They should be combined with each other.Comprehensive consideration,evaluation of cervical invasion,magnetic resonance imaging shows advantages,but further confirmation.Older,overweight,postmenopausal vaginal bleeding,hypertension,and diabetes are risk factors for endometrial cancer.