| Objective:The aim of this study was to measure platelet parameters such as PLT,PDW,MPV,PCT,and serum carbohydrate antigen(CA)125 in patients with normal endometrial,endometrial hyperplasia(EH,and endometrial cancer(EC)before surgery.They were analyzed retrospectively.Determine the correlation between the above indexes and endometrial pathology,to evaluate the predictive value of single and combined detection for endometrial carcinoma,and to find the best diagnostic threshold to guide the diagnosis and treatment of endometrial carcinoma.Methods:The clinical data of patients who underwent abnormal vaginal bleeding or fluid in our hospital and underwent endometrial pathology from January 2012 to January 2018 were collected.Record the serum CA125 and the blood routine indicators obtained by the patient before diagnostic curettage,and the pathological report after the clinical operation(including diagnostic curettage).The pathological results were used as the basis for the diagnosis of the patient.Among them,211 patients with EC were established as endometrial cancer group;106 patients with endometrial hyperplasia were established as endometrial hyperplasia group;69 patients with normal endometrial type were established as normal endometrium group.The ANOVA test or Kruskal-Wallis test was used to compare the data between the groups.The ROC was used to obtain the best diagnostic boundary values of serum CA125,PLT,PDW and MPV.And compare the value of the above indicators in the prediction of EC alone and in combination,and analyze the relationship between the above indicators and the pathological features of EC patients,in order to further evaluate the condition of EC patients and guide treatment.Results:1.Clinical features:A total of 386 patients were included in the study,all of which showed abnormal vaginal bleeding or fluid,and all underwent endometrial pathology.Among them,211 patients with endometrial cancer,the age was(55.17±8.37)years;106 patients with endometrial hyperplasia,the age was(53.49±8.92)years;69 patients with normal endometrium,the age was(52.88±10.13)years.2.Preoperative hematology-related indicators were compared:three groups of WBC,Hb and PCT were compared(P=0.675,P=0.145,P=0.051,P>0.05),the difference was not statistically significant.The PLT,PDW,and MPV were the highest in the endometrial cancer group and the lowest in the normal endometrium group,and the difference was statistically significant(P=0.005,P=0.048,P=0.001,P<0.05);the difference was not significant in the endometrial hyperplasia group compared with the endometrial cancer group and the normal endometrium group(P>0.05).The level of serum CA125 in the endometrial cancer group was(33.60±56.57)U/ml,the level of serum CA125 in the endometrial hyperplasia group was(14.90±6.65)U/ml,and the level of serum CA125 in the normal endometrium group was(13.58±5.59)U/ml.The difference was statistically significant(P<0.05);the difference between the endometrial hyperplasia group and the normal endometrium group was not significant(P>0.05).3.ROC curve analysis:The AUC of serum CA125,PLT,PDW,and MPV alone predicting endometrial cancer were 0.738,0.560,0.568,and 0.583,respectively(P=0.000,0.043,0.021,and 0.029).The AUC when the four indicators were combined to predict endometrial cancer was 0.771,which was higher than the AUC of the EC predicted by individual and any combination(P<0.001).The optimal cut-off value of serum CA125 was 21.38 U/ml;The sensitivity,specificity and accuracy were 0.49,0.89 and 66.06%,respectively.The optimal threshold of PLT was 221.50×109/L;The sensitivity,specificity and accuracy were 0.89,0.28,and 61.40%,respectively.The optimal cut-off value of PDW was 11.85 fL;The sensitivity,specificity,and accuracy were 0.57,0.59,and 56.74%,respectively.The optimal cut-off value of MPV was 10.35 fL;The sensitivity,specificity,and accuracy were 0.53,0.63,and 58.29%,respectively.The optimal threshold was 0.55 for joint prediction;The sensitivity,specificity,and accuracy were 0.65,0.79,and 70.73%,respectively.4.Analysis of the relationship between postoperative pathological features:(1)With the increase of FIGO stage,the level of serum CA125 gradually increased(P<0.001),and the difference was statistically significant;(2)PLT,PDW,MPV and serum CA125 levels did not increase with increasing grades(P=0.978,P=0.110,P=0.136,P=0.763,P>0.05),the difference was not statistically significant;(3)The level of serum CA125 in Type I EC was significantly higher than that of type II EC(P<0.001);(4)the level of PLT and serum CA125 in patients with positive cytology in peritoneal washings was significantly higher than that in negative patients(P<0.001);(5)The levels of PDW and MPV in patients with myometrial invasion depth?1/2 were significantly higher than those with infiltration depth<1/2(P=0.039,P=0.008,P<0.05),and the difference was statistically significant.Conclusions:1.Serum CA125,PLT,PDW,and MPV may be potential markers for predicting endometrial cancer.The accuracy of combined detection of four indicators is higher than that of individual detection.2.The higher the level of serum CA125 and PLT,the greater the probability that the peritoneal lavage fluid will detect tumor cells,and the serum CA125 value is positively correlated with the cancer stage.3.The higher the level of PDW and MPV,the greater the likelihood that the depth of myometrial invasion will reach or exceed 1/2.4.Abnormal vaginal bleeding or fluid discharge is the main clinical manifestation of people with endometrial cancer,but it can also occur in partial patients with endometrial hyperplasia and normal endometrial types.Therefore,for this part of the population,the level of serum CA125,PLT,PDW and MPV can be used to guide the diagnosis direction and reduce the occurrence of missed diagnosis or misdiagnosis. |
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