Retrograde Study Of Uterine Sarcoma And Methods Of Distinction From Benign Leiomyoma

ObjectiveUterine sarcoma is a rare malignant tumor with a very low incidence,but high degree of malignancy and very poor prognosis and displays aggression in behavior.This study analyzed the correlation between the clinicopatholo-gical features of Endometrial stromal sarcoma(ESS)and uterine leiomyoma and we further studied and explored use of guiding significance of magn-etic resonance imaging techniques to differentiate uterine sarcoma from benign leiomyoma in clinical diagnosis.MethodsRetrograde study of patients was done.The clinical data of 92 patients with Endometrial stromal sarcoma and benign leiomyoma.Histopathaological specimens revealed 12 patients with uterine sarcoma and 80 patients with benign leiomyoma.The data was compared of all patients who underwent laparoscopic surgery because of uterine fibroids and uterine sarcomas at First Affiliated Hospital of Taishan Medical University between January 2013 and June 2017.Files were collected from medical records containing information about patients age,menopause status,clinical manifestation,a rapidly grow-ing uterine mass,large uterine size,CA125,LDH,MRI,endometrial curettage and ultrasound.The database were analysis with SPSS 20.0 version Chicago USA for windows.Baseline MRI characteristics was obtained from the record and compared along with the laboratory findings.ResultsHistopathological specimens revealed 12/92 patients with uterine sarcoma.Multivariate analysis of factors differentiating uterine sarcomas from uterine fibroids was achieved using logistic regression.The average age of onset of subclinical uterine sarcoma and benign leiomyoma was 44 years(14-68 years of age,average age 46.5 years and 28-71 years of age,average age 46.5years)respectively.The average age of onset of uterine sarcoma was longer than that of uterine leiomyoma.According to Mann-Whitney U-test analysis the clinical symptoms between the two patients group regarding CA125,Hemoglobin,Neutrophil,lymphocyte,NLR,and MRI show no statistical difference in tumor size and ADC value(10-3mm2/s)(P>0.05).And accord-ing to logistic regression factor analysis showed that the DWI signals of the both patients were MRI,the composition of the lumps(solid or mixed),and the unclear boundaries of the masses.There was significant difference in DWI signals,components(cystic and mixed),and except the heterogeneity in the T2WI(P=0.000)(P<0.05).There was significant difference in Margin(unclear)for Endometrial stromal sarcoma(ESS)and Benign leiomy-oma(BL)(P=0.012)(P<0.05).There was significant difference in the mean Apparent diffusion coefficient(ADC)(10-3mm2/s)value for Uterine Sarcoma(US)and Uterine Fibroids(P=0.008)(P<0.05).ConclusionEndometrial stromal sarcoma is more late than the median age of uterine leiomyoma.It is difficult to identify two tumors by clinical symptoms and related laboratory examination(pre-operative CA125,LDH etc)and then combined with pelvic MRI examination,MRI diffusion weighted Imaging has a clinical guiding,significance for the establishment of pre-operative diagnosis and treatment scheme.Diffusion weighted image of MRI showed distinguishing difference between Malignant Sarcoma and Benign Leiomy-oma.