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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2003 October;162(5):111-5
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
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.