Yujie Li1, Peishan Cong1, Pan Wang1, Chong Peng1, Mingjun Liu1, Guirong Sun2. 1. Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China. 2. Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China. sunguirong@hotmail.com.
Abstract
PURPOSE: To evaluate the risk factors for pelvic lymph node metastasis (LNM) in endometrial cancer (EC). METHODS: Clinicopathological characteristics and preoperative laboratory results were retrospectively analyzed in 393 surgically staged patients with EC (January 2014-February 2019). RESULTS: Pelvic LNM was detected in 45 (11.5%) patients. Univariate analysis showed that increased preoperative levels of human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), and decreased absolute lymphocyte count (ALC), as well as non-endometrioid histology, grade 3 tumor, deep myometrial invasion, vaginal or para-uterine involvement, adnexal involvement, positive peritoneal cytology, and lymphovascular space invasion (LVSI) were risk factors for pelvic LNM (All p < 0.05). Multivariate analysis revealed that preoperative serum HE4 ≥ 132 pmol/L (odds ratio (OR) 4.25, 95% confidence interval (CI) 1.65-10.94, p = 0.003), serum CA 125 ≥ 27.6 U/mL (OR 6.10, 95% CI 2.31-16.07, p = 0.000), non-endometrioid histology (OR 16.64, 95% CI 5.96-46.47, p = 0.000), myometrial invasion ≥ 50% (OR 5.30, 95% CI 2.07-13.55, p = 0.001), positive peritoneal cytology (OR 4.70, 95% CI 1.21-18.27, p = 0.025), and LVSI (OR 3.11, 95% CI 1.09-8.92, p = 0.034) remained as independent risk factors for pelvic LNM in EC. With the increase of these independent risk factors, the rate of pelvic LNM was increased significantly. CONCLUSIONS: Higher preoperative levels of serum HE4 and CA125, non-endometrioid histology, deep myometrial invasion, positive peritoneal cytology, and LVSI are independent risk factors for pelvic LNM in EC, which can provide scientific basis for lymphadenectomy.
PURPOSE: To evaluate the risk factors for pelvic lymph node metastasis (LNM) in endometrial cancer (EC). METHODS: Clinicopathological characteristics and preoperative laboratory results were retrospectively analyzed in 393 surgically staged patients with EC (January 2014-February 2019). RESULTS: Pelvic LNM was detected in 45 (11.5%) patients. Univariate analysis showed that increased preoperative levels of human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), and decreased absolute lymphocyte count (ALC), as well as non-endometrioid histology, grade 3 tumor, deep myometrial invasion, vaginal or para-uterine involvement, adnexal involvement, positive peritoneal cytology, and lymphovascular space invasion (LVSI) were risk factors for pelvic LNM (All p < 0.05). Multivariate analysis revealed that preoperative serum HE4 ≥ 132 pmol/L (odds ratio (OR) 4.25, 95% confidence interval (CI) 1.65-10.94, p = 0.003), serum CA 125 ≥ 27.6 U/mL (OR 6.10, 95% CI 2.31-16.07, p = 0.000), non-endometrioid histology (OR 16.64, 95% CI 5.96-46.47, p = 0.000), myometrial invasion ≥ 50% (OR 5.30, 95% CI 2.07-13.55, p = 0.001), positive peritoneal cytology (OR 4.70, 95% CI 1.21-18.27, p = 0.025), and LVSI (OR 3.11, 95% CI 1.09-8.92, p = 0.034) remained as independent risk factors for pelvic LNM in EC. With the increase of these independent risk factors, the rate of pelvic LNM was increased significantly. CONCLUSIONS: Higher preoperative levels of serum HE4 and CA125, non-endometrioid histology, deep myometrial invasion, positive peritoneal cytology, and LVSI are independent risk factors for pelvic LNM in EC, which can provide scientific basis for lymphadenectomy.
Entities:
Keywords:
Carbohydrate antigen 125; Endometrial cancer; Human epididymis protein 4; Pelvic lymph node metastasis; Risk factors