Analysis Of The Clinical Value Of MRI And HE4 In Pre-operative Staging Of Endometrial Carcinoma

Objective: To analyze the difference of HE4 in endometrial carcinoma patients with different stages,different pathological characteristics and lymph node metastasis,to explore the value of MRI in preoperative staging of endometrial carcinoma.Meanwhile,this study was designed to analyze the clinical value of HE4 combined with MRI in endometrial carcinoma,which provides a reliable basis for determining lymph node metastasis in endometrial carcinoma before operation.Methods: Collect the 106 cases with endometrial carcinoma from October 2012 to October 2017 at Huaihe clinical college of Henan University.Exclusive criteria:(1)Heart,blood,kidney,respiratory diseases and / or liver dysfunction.(2)Presence of other system malignancies.(3)Received preoperative radiotherapy or chemotherapy before.82 cases were selected according to inclusion and exclusion criteria,the age ranged from 24 to 78 years old,with an average of 56 ±11.56 years.MRI and HE4 were performed in all patients 2 weeks before operation and endometrial carcinoma was diagnosed by rapid pathological examination before or during operation.According to the 2009 FIGO(International Federation of Gynecology and Obstetrics)staging of endometrial cancer: phase I: 53 cases,phase II: 8 cases,phase III: 13 cases,phase IV: 8 cases;there were 68 cases of adenocarcinoma and 14 cases of special pathological type,16 cases of cervical involvement and 12 cases of positive lymph nodes.The preoperative MRI staging and HE4 level were compared with the postoperative pathological staging by SPSS22.0 to analysis the value of MRI and HE4 single or combined application in preoperative staging of endometrial carcinoma.Results: 1.Positive correlation between HE4 level and endometrial carcinoma stage(P<0.05).There was significant difference in HE4 level between different depth of myometrial invasion(P<0.05).Meanwhile,compared with non-metastasis,the level of HE4 in Lymph node metastasis had significant difference.There was no significant difference in HE4 level between different pathological types(P>0.05).2.The accuracy of MRI for the evaluation of endometrial carcinoma of myometrial invasion,cervical stromal involvement and lymph nodes metastasis were 96.34%,92.68%,96.34%,which is of guiding significance for the selection of surgical methods.3.Diagnosis of lymph nodes metastasis by MRI and positive results of HE4 pre-operative were independent risk factor for lymph nodes metastasis,and a combination has been shown beneficial to preoperative evaluation.Conclusion: MRI has a high accuracy in detecting whether endometrial carcinoma invades the cervix and lymph nodes metastasis,in particular,the accuracy of the invasion of deep myometrium was 96.34%,which is helpful to select the proper excision area of operation.The results of preoperative MRI and serum HE4 combined with the endometrial biopsy can reduce the pelvic lymph node dissection rate,the excision area and time of operation and the postoperative complications.