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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

Copyright © 2003 EDIZIONI MINERVA MEDICA

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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