Preoperatif Belirteçlerin Endometriyal İntraepitelyal Neoplazi Hastalarında Endometriyum Kanserini Öngörmedeki Rolü

Year 2022, , 128 - 133, 22.09.2022

Caner Kose , Büşra Körpe , Vakkas Korkmaz , Yaprak Ustun

https://doi.org/10.46969/EZH.1136385

Abstract

Amaç: Endometriyal intraepitelyal neoplazi (EIN) tanısı olan kadınlarda preoperatif belirteçlerin endometriyal kanser (EC) için prediktif değerini belirlemektir.
Gereç ve Yöntem: Ocak 2014 ile Aralık 2021 yılları arasında tersiyer bir merkezde preoperatif endometriyal biyopsi sonucu EIN olan 611 hasta retrospektif olarak incelendi. Dahil edilme kriterlerini karşılayan 181 hasta çalışmaya alındı ve nihai patoloji sonuçlarına göre üç gruba ayrıldı: Grup 1’e benign sonuçları olan 60 hasta, grup 2’ye EIN olan 71 hasta ve grup 3’e EC olan 50 hasta dahil edildi. Üç grup arasında demografik, klinik ve biyokimyasal özellikler karşılaştırıldı. EIN’de eşzamanlı endometriyal kanser için Ca125’in prediktif değerini belirlemek için ROC analizi kullanıldı.
Bulgular: Ortalama preoperatif Ca125≥ 35U/ml seviyeleri üç grup arasında farklıydı (38.02±2.73, 41.61±6.19, 63.63±39.78, p<0.001, sırasıyla). Ca125 düzeyi en yüksek Gr3’teydi (65.8+41.7). Gr1 ile Gr3 ve Gr2 ile Gr3 arasındaki fark istatistiksel olarak anlamlıydı (p=0.017, p=0.024 sırasıyla). Ca125 cut-off değeri %70.3 duyarlılık ve %69.2 özgüllük oranı ile 41.25U/mL olarak belirlendi. Postmenopozal hasta sayısı da (n=35) kanser grubunda en yüksekti. Premenopozal dönemdeki hastaların endometriyal kalınlıkları karşılaştırıldığında üç grup arasındaki fark istatistiksel olarak anlamlıydı (9.25±4.2, 12±5.87, 15±6.87 mm, p<0.001, sırasıyla) ve en yüksek değer kanser grubunda bulundu.
Sonuç: Ca125 düzeyi özellikle postmenopozal dönemde EIN tanısı alan kadınlarda endometriyum kanserini tahmin etmede kullanılabilir. Bu konuda yapılacak çalışmalarla bu bilgi desteklenmelidir.

Keywords

Endometriyal İntraepitelyal neoplazi, Endometriyal kanser, preoperative Ca125

Thanks

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Predictive Value of Preoperative Markers in Endometrial Intraepithelial Neoplasia for Concurrent Endometrial Cancer

Abstract

Aim: The purpose of this study was to determine the predictive value of preoperative markers for endometrial cancer in endometrial intraepithelial neoplasia (EIN).
Materials and Methods: Six hundred eleven patients with EIN were retrospectively studied at a tertiary referral center in Turkey between January 2014 and December 2021. 181 patients with EIN who met the inclusion criteria were enrolled in the study and divided into three groups according to the final pathological results: Group 1 with benign findings (n=60), Group 2 with EIN (n=71) and Group 3 with endometrial cancer (n=50). Demographic, clinical and biochemical characteristics were compared among the three groups. Receiver operating characteristic analysis (ROC) was used to evaluate the predictive value of Ca125 for concurrent endometrial cancer in EIN.
Results: Mean preoperative Ca125≥35U/mL levels were different among three groups (38.02±2.73, 41.61±6.19, 63.63±39.78, p<0.001, respectively). The highest value of Ca125 level was found in cancer group and difference within pairs were statistically significant (p<0.001). The cut-off value was detected as ≥41.25U/mL for Ca125 and sensitivity, specificity were 70.3 %, 69.2 %, respectively (p<0.001). Number of postmenopausal patients (n=35) was also highest in the cancer group. Premenopausal endometrial thickness was different among three groups also (9.25±4.2, 12±5.87, 15±6.87 mm, p<0.001, respectively) and highest value was in cancer group.
Conclusion: Ca125 level could be used in prediction of endometrial cancer especially in postmenopausal women. The optimal cutoff value determined in our study could be considered in predicting endometrial cancer in EIN.

Keywords

Endometrial intraepithelial neoplasia (EIN), preoperative Ca125, endometrial cancer

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