| Objective:To compare preoperative MRI examination and serum CA-125 with postoperative pathology and to explore the clinical significance of preoperative MRI examination and tumor marker CA-125 in endometrial carcinoma patients.Methods:60 patients of endometrial carcinoma,who were admitted to the Department of Obstetrics and Gynecology,QiLu Hospital,Shandong University,participated our study,during December 2005 to December 2015.All patients received preoperative MRI examination and serum CA-125 testing,and the clinical data were complete.The other healthy subjects were enrolled in control group,and everyone got serum CA-125 testing.Statistical software was utilized to compare MRI examination and serum CA-125 with pathological staging,respectively.Also,assessment value of serum CA-125 in mucosal invasion,cervical invasion and lymph node metastasis was analyzed.At last,based on the pathological examination,the assessment value of MRI examination and serum CA-125 in mucosal invasion,cervical invasion and lymph node metastasis was analyzed.Results:1.Clinical characteristics of the patients1.1 General informationThe average age of the sample was 53.7±9.3 years old(with a range of 25?78 years of age).Of all patients,39 cases(65.0%)had gone through the menopause,and 21 cases were un-menopausal women.1.2 FIGO stagingBased on the FIGO staging,45 cases(75.0%)were in stage ? A,4 cases(6.7%)were in stage ? B,5 cases(8.3%)were in stage ?,5 cases(8.3%)were in stage? and one patient was in stage ?.1.3 Pathological gradeIn terms of pathological grade,well differentiated cancer occurred in 36 patients(60.0%),moderately differentiated cancer occurred in 14 patients(23.3%),and low differentiated cancer occurred in 10 patients(16.7%).1.4 Histological typeIn terms of histological type,54 patients(90.0%)were endometrioid adenocarcinoma and 6 patients(10.0%)were non endometrioid adenocarcinoma.2.Different examinations compared with pathologic diagnosis.2.1 MRI compared with FIGO staging2.1.1 Over all detection rate of MRI examination was 81.7%(49/60).2.1.2 Over all accuracy rate of MRI examination was 77.6%(38/49).2.1.3 Consistency checks showed MRI examination and pathological examination were in line with each other in staging.2.2 Different values of preoperative CA-125 in clinic pathological aspects2.2.1 Difference of CA-125 between study group and control groupComparing the preoperative serum CA-125 level of cancer patients and control group,the parameters showed a significant relationship(U=872.0,P=0.000).2.2.2 CA-125 compared with FIGO staging Based on the FIGO staging,high CA-125 level had significant relationship with pathological stages(x2=9.080,P=0.011).2.2.3 CA-125 compared with pathological characteristics2.2.3.1 CA-125 compared with Myometrial invasionThe positive rate of serum CA-125 was significantly related to myometrial invasion(x2=7.581,P=0.023).2.2.3.2 CA-125 compared with Cervical invasionThe positive rate of serum CA-125 was significantly associated with cervical invasion(x2=4.055,P=0.044).2.2.3.3 CA-125 compared with Lymphatic metastasisThe positive rate of serum CA-125 was significantly related tolymphatic metastasis(x2=4.485,P=0.034).3.Preoperative MRI compared with serum CA-1253.1 The suitable cut-off value for CA-125According to the ROC curve,we arrived that the cut-off value was 25.075U/ml.The area under the ROC curve was 0.758.The positive rates of serum CA-125 was 46.7%.The sensitivity and specificity were 46.7%and 93.7%,respectively.3.2 MRI compared with CA-125 in pathological characteristics3.2.1 MRI compared with CA-125 in FIGO stagingComparing the diagnosis of pathological stages of MRI examination and positive rate of serum CA-125,preoperative MRI diagnosis sensitivity was similar to the positive rate of serum CA-125(x2=3.693,P=0.158).3.2.2 MRI compared with CA-125 in myometrial invasionAssessing myometrial invasion or not,there was no statistically significant differences between MRI diagnosis sensitivity and the positive rate of serum CA-125(x2=3.211,P=0.073).3.2.3 MRI compared with CA-125 in Lymphatic metastasisIn the aspect of lymphatic metastasis,the two ways were not statistically significant(x2=1.487,P=0.223).3.2.4 MRI compared with CA-125 in cervical invasionThe diagnostic sensitivity of MRI assessing cervical invasion or not was 60.0%(3/5),97.7%(43/44),while the positive of serum CA-125 was 62.5%(5/8),44.2%(23/52).The two diagnostic methods were statistically significant(X2=4.603,P=0.032).Conclusions:1.MRI and serum CA-125 testing are of great important tool for diagnosis of endometrial carcinoma.2.Preoperative MRI examination and serum CA-125 in the diagnosis of staging,myometrial invasion,cervical invasion and lymphatic metastasis are of great importance. |
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