Department of Gynecology and Obstetrics, F. D. Roosevelt Teaching Hospital, Banská Bystrica, Slovakia.
Department of Gynecology and Obstetrics, Faculty of Medicine, L. Pasteur Teaching Hospital Košice, P. J. Safarik University, Košice, Slovakia.
Minim Invasive Ther Allied Technol. 2023 Feb;32(1):12-17. doi: 10.1080/13645706.2022.2153342. Epub 2022 Dec 21.
Endometrial cancers are among the epithelial malignancies of the lining of the uterine cavity. The invasion of carcinoma into the lymphovascular space (LVSI) is considered a risk factor for the course of the disease.
We evaluated 170 female patients. Our primary objective was to find any difference in the incidence of LVSI in female patients treated with and without an intrauterine manipulator. In addition, we analyzed the effect of the type of intrauterine manipulator used on the incidence of LVSI, tumor grading, myometrial invasion, and the method of obtaining primary histology with regard to the incidence of LVSI.
Using a manipulator during surgery was not associated with LVSI (with a manipulator without, 11.5 21.7%; OR 1.8; 95% CI 0.73-4.39; = 0.199). However, the method used to obtain the primary histology had a statistically significant effect on the incidence of LVSI in our set (-value = 0.011).
In our study, we did not confirm the effect of a uterine manipulator on the possible increase of LVSI positive cases. The secondary analysis indicated a higher incidence of LVSI in the female patients diagnosed with curettage than in those who underwent hysteroscopy. Trail is registered in ClicincalTrails.gov with identifier: NCT05261165.
子宫内膜癌是子宫腔内膜的上皮恶性肿瘤之一。癌侵犯淋巴管血管空间（LVSI）被认为是疾病进程的一个危险因素。
我们评估了 170 名女性患者。我们的主要目的是确定在使用和不使用宫内操作器治疗的女性患者中 LVSI 的发生率是否存在差异。此外，我们分析了使用的宫内操作器的类型对 LVSI 的发生率、肿瘤分级、肌层浸润以及获得原发性组织学的方法的影响。
手术中使用操作器与 LVSI 无关（有操作器者为 11.5%，无操作器者为 21.7%；OR 1.8；95%CI 0.73-4.39； = 0.199）。然而，我们的研究组中，获得原发性组织学的方法对 LVSI 的发生率有统计学显著影响（-值=0.011）。
在我们的研究中，我们没有证实宫内操作器对 LVSI 阳性病例增加的影响。二次分析表明，刮宫诊断的女性患者 LVSI 发生率高于宫腔镜检查者。该研究已在 ClinicalTrials.gov 注册，标识符为：NCT05261165。
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