| Preface Endometrial carcinoma(EC) is the most commom malignancy of the female genital tract .The incidence has been increasing in recent years.Although two thirds patients with endometrial cancer are diagnosed as early stage ,the five-year survival was decreased 4% compared with that in 1970's.So,the patients with early stage should be treated according to high risk factors. The depth of myometrial invasion was involved in the staging system of the International Federation of Gynecology and Obstetrics(FIGO) in 1988. But it was based on staging surgery and postoperative histological examination .By far there is no reliable non-histological means for evaluating the depth of myometrial2003invasion.At present, non-histological means for evaluating the depth of myometrial invasion include a gross evaluation and imaging techniques.The imaging techniques include MRI ,CT, transvaginal sonography(TVS) and color Doppler flowing image(CDFI).MRI is the most effective due to its excellent resolution of contrast of soft tissue.But it can't be used widely because of its higher cost-effective.CT is expensive and less effective than MRLThere is controversy of CDFI in evaluating the depth of myometrial invasion.TVS is a simple and non-invasive method, which has high discrimination. So it has been widely used to assess the depth of MI.However TVS could only provide the information of two planes and was lack of objective quantity parameters, so it has low sensitivity and specificity to detect the depth of myometrial invasion of endometrial cancer.Therefore , it is necessary to study a more effective sonographic method. The objectives of the study are:1. To investigate the value of multiplanar mode reconstruction of three dimensional transvaginal sonography(3D-TVS) in diagnosis of depth of MI2. To evaluate the role of measurements of uterine and tumor volume by 3D-TVS in detection of deep MI.3.To set up a combined score system to diagnose deep MI.2003Materials and Methods Fifty-three patients with apostoperative histological-proven endometrial carcinoma from Women's Hospital, Zhejiang University between 2002 to 2003 were included in the study. All Patients underwent primary surgery and submitted to TVS and 3D-TVS within 7 days before operation.The diagnosis of the depth of MI by TVS and 3D-TVS was made according to the criteria of Olaya. The uterine and tumor volume were obtained based on 3D-TVS. In the meantime, the following parameters were recorded:1) Clinical parameters:age,weight index,menopause,the duration of postmenopause,FIGO stage and serum CA125.2) Preoperative histological parametersrhistological type ,tumor grade.3) Postoperative parameters:histological type,tumor grade,cervical involvement,lymph-vascular space involvement.complicated with myoma and adenomyosis.4) Postoperative immunohistochemistry parameters: estrogen receptor (ER), progesterone receptor (PR), P53, and proliferating cell nuclear antigen (PCNA)The Postoperative histological diagnosis was used as the gold standard for diagnosis of the depth of MI. X2 test, Mann-Whitney U test,Receiver operating characteristic(ROC) curve,Logisticregression were used to compare the advantages of 2D-TVS and 3D-TVS in detection of the depth of MI.To compare the difference of uterine volume and tumor volume between superficial and deep MI, a logistical regression equation of tumor volume and deep MI was established. All the data were statistically managed with SPSS 10.0 for windows. By analyzing the parameters that affected the accuracy of 3D-TVS or were related to deep MI, a combined score system was established. Results 1 .postoperative histological resultsEighteen of the patients were deep MI,thirty-one superficial MI and four no myometrial involvement. 2.3D-TVS results(1) Imaging features were observed by 3D-TVS multiplanar mode reconstruction. The endometrium-myometrium interphase was clearly outlined and local endometrium was thick...
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