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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2003 October;162(5):111-5

language: Italian

Role of ultra­so­nog­ra­phy and ­tumor mark­ers in the diag­no­sis of asymp­to­mat­ic endo­me­tri­al can­cer

Bruno P., Capasso R., Bonifacio M., Pecoraro M., Votino C.

Dipartimento di Ginecologia ed Ostetricia, Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli “Federico II”, Napoli


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Aim. The impor­tance of ultra­so­nog­ra­phy com­pared ­with the unre­li­able ­tumor mark­ers as a screen­ing ­test of asymp­to­mat­ic endo­me­tri­al can­cer is dis­cussed.
Meth­ods. At the Obstet­ric and Gyne­co­log­ic Depart­ment of the Uni­ver­sity of ­Naples “Feder­i­co II”, a ret­ro­spec­tive ­study has ­been on 55 wom­en (­aged 41-86 ­years) suf­fer­ing ­from endo­me­tri­al can­cer. A pel­vic ultra­son­o­gaph­ic exam­ina­tion has ­been ­made ­with a 3.5 MHz sov­ra­pu­bic ­probe and a 7.5 MHz trans­vag­i­nal ­probe. ­Then, the fol­low­ing ­tumor mark­ers ­were ­dosed: Ca 125, Ca 19.9, Ca 15.3, CEA, α-fetop­ro­tei­na, β-HCG. The diag­nos­tic cri­te­ria ­were endo­me­tri­al thick­ness, his­te­rom­e­try and myo­me­tri­um echog­e­nic­ity. A his­to­log­i­cal exam­ina­tion was per­formed on biop­tic endo­me­tri­al sam­ples tak­en ­with ­Novak meth­od in 35 cas­es and an endo­me­tri­al curet­tage in 20 cas­es.
­Results. In 55 endo­me­tri­al can­cers, ­with con­clu­sive his­to­log­i­cal diag­no­sis, ultra­so­nog­ra­phy had sug­gest­ed ­this pathol­o­gy in 46 cas­es (83.7%) and 9 cas­es (16.3%) ­were ­false neg­a­tive. ­Tumor mark­ers ­were rec­og­nized as ­false neg­a­tive in 50 cas­es (90.9%) and pos­i­tive in 5 cas­es (9.09%). Endo­me­tri­al thick­ness was ­between 10 mm and 20 mm in 72.7% of cas­es, ­between 4 mm and 10 mm in 7.2%, ­over 20 mm in 20% of cas­es. Myo­me­tri­um was hypo­ech­o­gen­ic in 72.7% of the cas­es. The ute­rine vol­ume was ­over the aver­age in 81.8% of the cas­es.
Con­clu­sion. ­From the anal­y­sis of ­these ­data, ultra­so­nog­ra­phy, con­sid­er­ing endo­me­tri­al thick­ness, myo­me­tri­um echog­e­nic­ity and ute­rine vol­ume has a ­high sen­sibil­ity (83.7%) in the diag­no­sis of asymp­to­mat­ic endo­me­tri­al can­cer. Final­ly, ­tumor mark­ers, ­with 90.9% of ­false neg­a­tive, are an unre­li­able screen­ing ­test of endo­me­tri­al asymp­to­mat­ic can­cer.

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