Comparison Of Ki67 Index Of Dilation And Curettage Specimens With Postoperative Specimens In Endometrial Cancer

Background:Endometrial cancer is one of the three major malignant tumors in the female reproductive system,and its morbidity and mortality have increased year by year.The proliferative capacity of tumor cells is closely related to the prognosis of tumors.Immunohistochemical examination of ki67 has been widely used to evaluate tumor cell proliferation.A large number of studies have found that ki 67 expression is associated with prognosis of endometrial cancer,but the poor reproducibility and reliability of immunohistochemical examination of ki67 expression limits the clinical application of ki 67.Dilation and curettage is one of the main methods for preoperative diagnosis of endometrial cancer.Its advantages are higher sampling success rate,role of hemostasis effect,and sufficient endometrial tissue can be collected.However,the preoperative curettage specimens were often neglected for immunohistochemical examination.Objective:The purpose of this study was to retrospectively analyze the results of immunohistochemical staining of ki67 in dilation andcurettage specimens of endometrial cancer and postoperative specimens,to compare the results of the two specimens,and to explore how to assess tumor cell proliferation of endometrial cancer more accurately.Methods:The patients from the First Affiliated Hospital of Chongqing Medical University who were diagnosed as endometrial cancer by dilation and curettage and treated by surgery were selected from September 2015 to February 2019.81 patients who met the inclusion criteria were screened out.The clinical and pathological data of these patients were collected in detail.The results of immunohistochemical staining were reported as the percentage of ki 67 positive cells within the investigated cell population.The difference between postoperative and preoperative ki67 index within 20% was identified as not obvious.Compared with preoperative ki 67 index,the postoperative ki 67 index increased by 20% or more was identified as a significant increase,and the postoperative ki 67 results decreased by 20% or more was a significant decrease.The data was collected and statistically analyzed using spss 20.0 statistical software.Results:There were 81 patients enrolled in the study,and 63(78%)had differences in postoperative and preoperative ki 67 results,of which 43(53%)had a difference of more than 20%,and only 18(22%)with no difference.Of these patients 26(32%)had a significant reduction after surgery,and 17(21%)had a significant increase after surgery.Histological subtype,stage,depth of myometrial invasion,grade,diagnosis and surgicalinterval,and lymph node metastasis had no significant effect on the difference(P > 0.05).There is no significant difference between hysteroscopic dilation and curettage with direct dilation and curettage(p>0.05).Conclusion: For patients with endometrial cancer definitively diagnosed by dilation and curettage,there are significant differences between the postoperative specimen Ki 67 and the preoperative specimen ki 67.Histological subtype,stage,use of hysteroscope,depth of myometrial invasion,grade,diagnosis and surgical interval,and lymph node metastasis had no significant effect on the difference.For assessment of tumor tissue proliferation,data from preoperative endometrial tissue should be included in the overall score.