| Objective:In recent years,the number of new endometrial carcinoma cases and deaths has doubled,threatening the health of women worldwide.According to different clinical characteristics and biological behaviors,endometrial carcinoma is divided into type ?(estrogen-dependent)and type ?(non-estrogen-dependent,also known as special types of endometrial carcinoma).This study retrospectively analyzes the case data of patients with endometrial carcinoma treated in our hospital,explores the differences in clinical and pathological characteristics of the two types of endometrial carcinoma,and helps clinicians identify and distinguish high-risk endometrial carcinoma patients Appropriate treatment should be carried out in order to extend the survival time of patients and reduce the mortality rate to achieve the best effect.Methods:The clinical and pathological data of 373 cases(319 type ? and 54 type ?)patients with endometrial carcinoma who were admitted to our hospital and received surgical treatment from January 2013 to December 2018 were collected and processed using SPSS 23.0 software.Statistical analysis was performed to compare the clinical and pathological features of patients with type ? and type ? endometrial carcinoma.Result:1.Comparison between groups The average age of onset of type ? endometrial carcinoma(53.9±8.4)and type ? endometrial carcinoma(60.6±8.2)were significantly different(P=0.000);Patients with type ? endometrial carcinoma were analyzed to compare the differences in menopausal status,clinical symptoms,and hypertension(P<0.05).There was no significant difference in non-fertile,diabetic and smokers(P>0.05).2.The median values of serum CA125 and HE4 of patients with type ? endometrial carcinoma before surgery were 19.7U/ml and 109.0pmol/L,respectively.The abnormally elevated patients accounted for 19.1%(61/319)and 24.4%(40/170);The median values of serum CA125 and HE4 of type ? patients before surgery were 24.6U/ml and 136.0pmol/L,respectively,with abnormally elevated patients accounting for 33.3%(18/54)and 41.0%(16/37).Comparative analysis showed that the levels of serum CA125 and HE4 in patients with type ? endometrial carcinoma before surgery and the proportion of patients with abnormally elevated levels were higher than those in type ?,and the differences were significant(P<0.05).3.Among the 348 patients whose pathology was"endometrial carcinoma"before and after surgery,289 cases of endometrioid carcinoma and 42 cases of special types of endometrial carcinoma were diagnosed as before.The diagnostic test found that the Kappa value of the two pathological results was 0.803(P=0.046);The preoperative diagnosis method was 93.0%(173/186)for pathological diagnosis with hysteroscopy combined with curettage,which was higher than that with simple curettage The rate was 84.5%(158/187)(?~2=6.772;P=0.009).4.There were 288 patients(90.8%)in the early stage(stage I+II)of type ? endometrial carcinoma,31 patients(9.7%)in the late stage(stage III+IV),and 35patients in the early stage(stage I+II)type ?(64.8%),late(stage III+IV)19 cases(35.2%),compared with type ?,type ? patients are diagnosed more late(?~2=25.804;P=0.000);Comparison between groups,type ? What are the lesions in patients with endometrial carcinoma(?~2=7.423;P=0.006),deep uterine muscle infiltration(?~2=10.300;P=0.001),vascular cancer thrombus(?~2=19.509;P=0.000),abdominal cavity irrigation The positive rate of liquid cytology was high(?~2=9.866;P=0.002),the positive expression rate of mutant p53 and Ki-67 was high(P=0.000),and the positive expression rate of ER and PR was low(P=0.000).Conclusion:1.Compared with type ? endometrial carcinoma,patients with type ? endometrial carcinoma are older,most of them are postmenopausal women,and the first symptoms are"vaginal drainage,lower abdominal discomfort".2.Serum CA125 and HE4 expression levels of type ? endometrial carcinoma before surgery were higher than those of type ?,and there were more patients with abnormally elevated serum CA125 and HE4 before surgery.3.Compared with the pathology after hysterectomy,the consistency of the preoperative diagnosis of the type of curettage was higher;compared with the simple diagnosis of curettage,the coincidence rate of pathological diagnosis of combined curettage with hysteroscopy was higher.4.Compared with type ? endometrial carcinoma,type ? endometrial carcinoma is diagnosed with more advanced and large lesions,with high-risk factors such as deep muscular infiltration of the uterus and vascular tumor thrombus.The positive rate of ascites or peritoneal lavage fluid cytology test and the positive expression rate of mutant p53 and Ki-67 is high,while the positive expression rate of ER and PR is low. |
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