Research into the Value of B-Mode Ultrasound, CT and MRI Examinations in the Diagnosis of Preoperative Myometrial Infiltration of Endometrial Cancer and Lymph Node Metastasis

Abstract This study is conducted to observe the diagnostic value of B-mode ultrasound, CT and MRI examinations in preoperative myometrial infiltration of endometrial cancer and lymph node metastasis. Retrospectively analyze 50 cases of the patients from Oct. 2010 to Aug. 2013. Before operation all the patients received dilatation & curettage to determine pathological diagnosis and clinical staging. There were 150 cases of patients who received B-mode ultrasound examination, wherein, 93 cases received CT examination and 57 cases received MRI examination as well. In the diagnosis of MIEC the diagnostic indicies of individual MRI examination were higher than that of individual B-mode ultrasound and CT examinations. Consistency of individual MRI examination with pathological diagnosis was significantly higher than that of B-mode and CT examinations. The sensitivity of CT and MRI was significantly higher than that of B-mode ultrasound examination. However, diagnostic indicators of B-mode ultrasound and CT joint examination were higher than B-mode ultrasound examination alone. The consistency of both with pathological diagnosis was significantly increased. B-mode and CT can significantly improve the diagnostic accuracy and has a good consistency with pathological diagnosis, thereby applicable to the clinical diagnosis of preoperative myometrial infiltration of endometrial cancer and lymph node metastasis.

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Diagnostic value of CT and MRI in the detection of paratracheal lymph node metastasis

Oral Oncology ◽

10.1016/j.oraloncology.2011.12.003 ◽

2012 ◽

Vol 48 (5) ◽

pp. 450-455 ◽

Cited By ~ 10

Author(s):

Thomas T.A. Peters ◽

Jonas A. Castelijns ◽

Redina Ljumanovic ◽

Birgit I. Witte ◽

C. René Leemans ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Diagnostic Value ◽

Node Metastasis ◽

Paratracheal Lymph Node ◽

Ct And Mri

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Serum miRNA-204-5p as a potential noninvasive biomarker for the diagnosis of endometrial cancer with sentinel lymph node mapping

10.21203/rs.3.rs-403149/v1 ◽

2021 ◽

Author(s):

Cailiang Wu ◽

Xuexin Zhou ◽

Jiayong Li ◽

Ruiying Xiao ◽

Ye Yang ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Node Metastasis ◽

Sentinel Lymph Node Mapping ◽

Diagnostic Value ◽

Lymph Node Mapping ◽

Node Metastasis ◽

Cancer Tissues ◽

Early Diagnostic

Abstract Background Lymph node status is one of the most important prognosis factors in determining adjuvant treatment in endometrial cancer (EC). However, lymphadenectomy bears significant surgical and postoperative risks. The use of the sentinel lymph node mapping (SLNM) has emerged as an alternative method to complete lymphadenectomy in EC. There remains controversy surrounding the SLNM in high-risk disease and its false negative rate (3%). We previously identified miR-204-5p is tumor suppressor miRNA associated with lymph node metastasis in endometrial cancer tissues. Here, we report serum miR-204-5p in EC patients have potential early diagnostic value combined with sentinel lymph node mapping. Methods The relative expression levels of miR-204-5p were detected by quantitative RT-PCR in the serum of 52 EC patients (total SLNM), 20 benign ovarian cyst patients and 20 myoma patients. The miR-204-5p expression was also detected in endometrial cancer tissues by in situ hybridization. Results Our results showed that serum miR-204-5p expression was down-regulated in EC patients than that in the benign ovarian cyst or myoma patients (p < 0.01).In accordance with final pathological evaluation, positive SLN EC patients have a significant lower level of miR-204-5p compared with negative SLN EC patients. The area under the ROC curve of miR-204-5p was 0.923, 95% CI(0.847, 1.000), and the diagnostic value with a sensitivity of 87.2% specificity of 80.0%. Conclusions Lower miR-204-5p expression is associated with lymph node metastasis in these SLN(+) EC tissues, indicate that down-regulation of serum miR-204-5p in EC patients have potential early diagnostic value combined with sentinel lymph node mapping.

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A nomogram prediction model for lymph node metastasis in endometrial cancer patients

BMC Cancer ◽

10.1186/s12885-021-08466-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhiling Wang ◽

Shuo Zhang ◽

Yifei Ma ◽

Wenhui Li ◽

Jiguang Tian ◽

...

Keyword(s):

Logistic Regression ◽

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

External Validation ◽

Clinicopathological Parameters ◽

Bootstrap Sample ◽

Multivariate Logistic Regression ◽

Node Metastasis ◽

Increased Risk

Abstract Background This study aimed to explore the risk factors for lymph node metastasis (LNM) in patients with endometrial cancer (EC) and develop a clinically useful nomogram based on clinicopathological parameters to predict it. Methods Clinical information of patients who underwent staging surgery for EC was abstracted from Qilu Hospital of Shandong University from January 1st, 2005 to June 31st, 2019. Parameters including patient-related, tumor-related, and preoperative hematologic examination-related were analyzed by univariate and multivariate logistic regression to determine the correlation with LNM. A nomogram based on the multivariate results was constructed and underwent internal and external validation to predict the probability of LNM. Results The overall data from the 1517 patients who met the inclusion criteria were analyzed. 105(6.29%) patients had LNM. According the univariate analysis and multivariate logistic regression analysis, LVSI is the most predictive factor for LNM, patients with positive LVSI had 13.156-fold increased risk for LNM (95%CI:6.834–25.324; P < 0.001). The nomogram was constructed and incorporated valuable parameters including histological type, histological grade, depth of myometrial invasion, LVSI, cervical involvement, parametrial involvement, and HGB levels from training set. The nomogram was cross-validated internally by the 1000 bootstrap sample and showed good discrimination accuracy. The c-index for internal and external validation of the nomogram are 0.916(95%CI:0.849–0.982) and 0.873(95%CI:0.776–0.970), respectively. Conclusions We developed and validated a 7-variable nomogram with a high concordance probability to predict the risk of LNM in patients with EC.

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Prospective evaluation of sentinel node navigation surgery in Japanese patients with low-risk endometrial cancer—safety and occurrence of lymphedema

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa252 ◽

2021 ◽

Author(s):

Hitoshi Niikura ◽

Asami Toki ◽

Tomoyuki Nagai ◽

Satoshi Okamoto ◽

Shogo Shigeta ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Lymph Node Metastasis ◽

Lower Extremity ◽

Lymph Node Biopsy ◽

Occurrence Rate ◽

Node Metastasis ◽

Node Biopsy

Abstract Objective The present study aimed to clarify the occurrence rate of lymphedema and prognosis in patients with endometrial cancer according to sentinel lymph node biopsy alone with intraoperative histopathological examination. Methods The study included 45 consecutive patients with endometrial cancer treated at Tohoku University Hospital between October 2014 and August 2017. All patients had endometrial carcinoma with endometrioid histology Grade 1 or Grade 2 confirmed by biopsy and stage I on magnetic resonance imaging and/or computed tomography at their preoperative evaluation. Sentinel lymph node detection was performed by radioisotope and dye. Patients who were diagnosed intraoperatively as negative for sentinel lymph node metastasis did not undergo further systematic pelvic lymphadenectomy. The occurrence rate of lymphedema and prognosis was evaluated. Results Bilateral sentinel lymph nodes were detected in 44 of 45 patients (97%). Forty-three patients underwent sentinel lymph node biopsy alone, and only two patients underwent systematic lymphadenectomy. Sentinel lymph node metastases were detected in one patient intraoperatively and two patients postoperatively as ITCs. No patients experienced recurrence. New symptomatic lower-extremity lymphedema was identified in one of 43 patients (2.3%) who underwent sentinel lymph node biopsy alone. Conclusion Sentinel lymph node biopsy alone with intraoperative histopathological diagnosis appears to be a safe and effective strategy to detect lymph node metastasis and to reduce the number of patients with lower-extremity lymphedema among patients with endometrial cancer.

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The incidence of pelvic lymph node metastasis by FIGO staging for patients with adequately surgically staged endometrial adenocarcinoma of endometrioid histology

International Journal of Gynecological Cancer ◽

10.1111/j.1525-1438.2007.00996.x ◽

2008 ◽

Vol 18 (2) ◽

pp. 269-273 ◽

Cited By ~ 121

Author(s):

D. S. Chi ◽

R. R. Barakat ◽

M. J. Palayekar ◽

D. A. Levine ◽

Y. Sonoda ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Myometrial Invasion ◽

Tumor Grade ◽

Pelvic Lymph Node ◽

Study Cohort ◽

Node Metastasis ◽

Figo Staging ◽

Pelvic Lymph Node Metastasis

The seminal Gynecologic Oncology Group study on surgical pathologic spread patterns of endometrial cancer demonstrated the risk of pelvic lymph node metastasis for clinical stage I endometrial cancer based on tumor grade and thirds of myometrial invasion. However, the FIGO staging system assigns surgical stage by categorizing depth of myometrial invasion in halves. The objective of this study was to determine the incidence of pelvic lymph node metastasis in endometrial cancer based on tumor grade and myometrial invasion as per the current FIGO staging system. We reviewed the records of all patients who underwent primary surgical staging for clinical stage I endometrial cancer at our institution between May 1993 and November 2005. To make the study cohort as homogeneous as possible, we included only cases of endometrioid histology. We also included only patients who had adequate staging, which was defined as a total hysterectomy with removal of at least eight pelvic lymph nodes. During the study period, 1036 patients underwent primary surgery for endometrial cancer. The study cohort was composed of the 349 patients who met study inclusion criteria. Distribution of tumor grade was as follows: grade 1, 80 (23%); grade 2, 182 (52%); and grade 3, 87 (25%). Overall, 30 patients (9%) had pelvic lymph node metastasis. The incidence of pelvic lymph node metastasis in relation to tumor grade and depth of myometrial invasion (none, inner half, and outer half) was as follows: grade 1–0%, 0%, and 0%, respectively; grade 2–4%, 10%, and 17%, respectively; and grade 3–0%, 7%, and 28%, respectively. We determined the incidence of pelvic nodal metastasis in a large cohort of endometrial cancer patients of uniform histologic subtype in relation to tumor grade and a one-half myometrial invasion cutoff. These data are more applicable to current surgical practice than the previously described one-third myometrial invasion cutoff results.

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One-step nucleic acid amplification vs ultrastaging in the detection of sentinel lymph node metastasis in endometrial cancer patients

Journal of Surgical Oncology ◽

10.1002/jso.25322 ◽

2018 ◽

Vol 119 (3) ◽

pp. 361-369 ◽

Cited By ~ 10

Author(s):

Jan Kosťun ◽

Martin Pešta ◽

Jiří Sláma ◽

Robert Slunéčko ◽

Pavel Vlasák ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Nucleic Acid ◽

Sentinel Lymph Node ◽

Lymph Node Metastasis ◽

Cancer Patients ◽

Nucleic Acid Amplification ◽

Sentinel Lymph Node Metastasis ◽

Node Metastasis ◽

One Step

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OC08.02: A preoperative risk model with ultrasound variables to assess lymph node metastasis in endometrial cancer patients: a model development and validation study by the IETA group

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.19255 ◽

2018 ◽

Vol 52 ◽

pp. 17-17

Author(s):

L. Eriksson ◽

E. Epstein ◽

A.C. Testa ◽

D. Fischerová ◽

L. Valentin ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Cancer Patients ◽

Validation Study ◽

Risk Model ◽

Model Development ◽

Preoperative Risk ◽

Node Metastasis ◽

Development And Validation

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Prediction of lymph node metastasis in patients with apparent early endometrial cancer

Obstetrics & Gynecology Science ◽

10.5468/ogs.2015.58.5.385 ◽

2015 ◽

Vol 58 (5) ◽

pp. 385 ◽

Cited By ~ 11

Author(s):

Joo-Hyuk Son ◽

Tae-Wook Kong ◽

Su Hyun Kim ◽

Jiheum Paek ◽

Suk-Joon Chang ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Node Metastasis

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Lymph Node Metastasis in Patients With Endometrioid Endometrial Cancer: Overtreatment Is the Main Issue

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000937 ◽

2017 ◽

Vol 27 (4) ◽

pp. 748-753 ◽

Cited By ~ 8

Author(s):

Alper Karalok ◽

Taner Turan ◽

Derman Basaran ◽

Osman Turkmen ◽

Gunsu Comert Kimyon ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Histological Grade ◽

Myometrial Invasion ◽

Lymph Node Involvement ◽

Node Metastasis ◽

Deep Myometrial Invasion ◽

Endometrioid Endometrial Cancer ◽

Grade 3

ObjectiveThe aim of this study was to evaluate the effectiveness of histological grade, depth of myometrial invasion, and tumor size to identify lymph node metastasis (LNM) in patients with endometrioid endometrial cancer (EC).MethodsA retrospective computerized database search was performed to identify patients who underwent comprehensive surgical staging for EC between January 1993 and December 2015. The inclusion criterion was endometrioid type EC limited to the uterine corpus. The associations between LNM and surgicopathological factors were evaluated by univariate and multivariate analyses.ResultsIn total, 368 patients were included. Fifty-five patients (14.9%) had LNM. Median tumor sizes were 4.5 cm (range, 0.7–13 cm) and 3.5 cm (range, 0.4–33.5 cm) in patients with and without LNM, respectively (P = 0.005). No LMN was detected in patients without myometrial invasion, whereas nodal spread was observed in 7.7% of patients with superficial myometrial invasion and in 22.6% of patients with deep myometrial invasion (P < 0.0001). Lymph node metastasis tended to be more frequent in patients with grade 3 disease compared with those with grade 1 or 2 disease (P = 0.131).ConclusionsThe risk of lymph node involvement was 30%, even in patients with the highest-risk uterine factors, that is, those who had tumors of greater than 2 cm, deep myometrial invasion, and grade 3 disease, indicating that 70% of these patients underwent unnecessary lymphatic dissection. A precise balance must be achieved between the desire to prevent unnecessary lymphadenectomy and the ability to diagnose LNM.

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