| BackgroundEndometrial carcinoma often coexists with adenomyosis.However,the prognosis of endometrial carcinoma with adenomyosis is still controversial.Objective:The objective of this study was to investigate the clinicopathological features of endometrial carcinoma complicated with adenomyosis and to investigate its prognosis.Methods:In this study,a total of 1343 patients admitted to our hospital from January 1,2017 to December 31,2020,all of whom were diagnosed as endometrial carcinoma by postoperative pathology after primary surgery,were included by retrospective analysis.Among them,338 patients(EC-A group,25.17%)showed adenomyosis,and 1005 patients(EC group,74.83%)showed no adenomyosis.Clinical and pathological data were collected,follow-up data were improved,and the two groups of data were compared and analyzed.SPSS26.0 software was used for statistical analysis of the data.After normality test,X±S was used to represent the results of measurement data with normal distribution,and t test was used for difference analysis.For measurement data with non-normal distribution,the results were represented by the median M,and the difference analysis was performed by non-parametric rank sum test.For counting data,the rate represents the result.Pearson Chi-square test is used for difference analysis.If the variable in the group is less than 5,continuity correction is used for difference analysis.Kaplan-Meier method was used for survival analysis,and it was considered that there was a statistically significant difference when P < 0.05.Results:1.Clinical characteristics: The average age of the EC-A group was 53.74±8.07 years old,and the average age of the EC group was 55.55±9.54 years old.The age of the EC-A group was small and the difference was statistically significant(P=0.001).There were 188 cases of menopausal patients in the EC-A group and 668 cases in the EC group,the difference was statistically significant(55.6% vs.66.5%;P < 0.001).2.Pathological features: endometrioid carcinoma was more common in the EC-A group(94.4% vs.88.5%;P=0.002),earlier operation-pathological stage(stage IA 76.6% vs.65.8%;P < 0.001),good tissue differentiation(G1/G2 84.6% vs.73.5%;P < 0.001),low infiltration of deep muscle layer(13.6% vs.23.6%;P < 0.001),less cervical invasion(8.0% vs.14.4%;P=0.002)and low lymphatic vascular infiltration(14.5% vs.23.2%;P=0.001),compared with EC group,the differences between the two groups were statistically significant.There were no significant differences in the rates of attachment metastasis,eluviation metastasis and postoperative adjuvant therapy between the two groups(P=0.754,P=0.258,P=0.07).3.Immunohistochemistry: There were no significant differences in the positive expression rates of p53,ER,PR and Ki-67 between the two groups(P=0.091,P=0.118,P=0.486,P=0.085).4.Molecular typing: Among all endometrial carcinomas,a total of 42 patients were tested for molecular typing.In EC group,there were 21 cases(63.6%)in POLE or NSMP group,and 12 cases(36.4%)in MSI or P53 group.In the EC-A group,there were 8 cases(88.9%)in the POLE or NSMP group,and 1 case(11.1%)in the MSI or P53 group.A higher proportion of POLE mutations or NSMP were found in the EC-A group than in the EC group,but the difference was not statistically significant(P=0.296).5.In the Kaplan-Meier analysis,the 5-year OS was 96.8% in EC-A group and 94.9% in EC group,and there was no significant difference between the two groups(P=0.773).The 5-year DFS was 95.5% in EC-A group and 95.1% in EC-A and 95.1% in EC group,and there was no significant difference between the two groups(P=1.000).In the Kaplan-Meier analysis,the 3-year OS was 93.2% in EC-A group and 93.5% in EC group,and there was no significant difference between the two groups(P=0.930).The 3-year DFS was 90.5% in EC-A group and 90.5% in EC-A and 90.5% in 3-year DFS in EC-A,and there was no significant difference between the two groups(P=0.995).Conclusions:1.Among patients with endometrial carcinoma,patients with adenomyosis usually have the following characteristics: younger age,early operating-pathological stage,better tissue differentiation,less deep muscle invasion,lower LVSI rate,and lower incidence of cervical invasion.2.Adenomyosis has no clear effect on overall survival for endometrial carcinoma. |
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