The Safety Of Diagnostic Hysteroscopy In Early Endometrial Carcinoma And The Prognosis Of Ascites Cell Positive

Objective: It is still controversial whether preoperative diagnostic hysteroscopy can lead to positive peritoneal cytology and influence prognosis.The prognostic significance of peritoneal cytology in patients with early-stage endometrial cancer remains unclear.This study aimed to investigate the safety of diagnostic hysteroscopy and the influence of positive peritoneal cytology on prognostic in patients with earlystage endometrial cancer.Methods: A retrospective analysis of 190 cases of early endometrial cancer in Dalian Obstetrics and Gynecology Hospital,which was confirmed by operation-pathology during January 2010 to 2013 December.The patients were confirmed as early endometrial carcinoma.The results were analyzed from the perspectives of age,complication of internal medicine,preoperative diagnostic means(hysteroscopy or traditional diagnostic curettage),cytology results of ascites,postoperative pathological data and follow-up time.Data was processed by SPSS18.0 system software.Single factor analysis and survival analysis were performed by Kaplan-Meier and Log-rank test.Multivariate prognostic analysis was conducted with Cox model.Refer to the related domestic and foreign literatures.Results:(1)Ascites positive rate diagnosed by traditional diagnostic curettage(11.43%)was lower than that diagnosed by hysteroscopy(15.29%).The results showed that preoperative hysteroscopy assisted curettage did not increase the ascites positive rate(p=0.433).(2)The 5 year survival rate of hysteroscopy group was 87.06% and curettage group was 93.33%.There was no significant difference between the two groups(p=0.142),that is,there was no significant effect of preoperative HSC on the survival time of patients with early endometrial cancer.(3)The single factor analysis of that age?60years(c2=16.509,P < 0.001),myometrial invasion depth?1/2(c2=8.308,P=0.004),cervical involvement(c2=3.888,P=0.048),tumor size > 2cm(c2=4.022,P=0.045)were the influence factors of positive peritoneal cytology with stage I-II endometrial carcinoma.(4)Univariate analysis: positive peritoneal cytology patients 5year survival rate was 76%,lower than the negative patients(92.73%)(c2=7.083,P=0.008);positive peritoneal cytology patients,the recurrence rate was 28%,higher than the negative patients(10.3%)(c2=6.161,P=0.013),indicating that PPWC is the prognostic factors of patients with early endometrial cancer.However,multifactor analysis showed that PPWC was not an independent risk factor for prognosis.Conclusion: For patients with early-stage endometrial cancer,preoperative HSC does not increase the positive rate of peritoneal washings cytology,nor does it affect the prognosis of patients.It is a safe preoperative examination method.This study also demonstrates that positive peritoneal cytology in patients with early-stage endometrial cancer is not an independent prognostic factor,but it is an influential factor and still needs more attention...