Liu Shihuang, Zhen Lan, Zhang Shaoyu, Cai Yurong, Lin Yanying, Chen Fulian, Li Xiaowen, You Qianru, Lai Xiaohong, Lai Hangbo, Zheng Xiangqin, Yi Huan
Department of Gynecology Oncology, Fujian Provincial Maternity and Children's Hospital, Fujian Provincial Key Gynecology Clinical Specialty, The Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
Department of Gynecology, Fuding Municipal Hospital, Zhangzhou, Fujian, China.
Front Med (Lausanne). 2023 Jan 9;9:1097133. doi: 10.3389/fmed.2022.1097133. eCollection 2022.
Hysteroscopy is a useful procedure for diagnosing endometrial cancer. There is controversy regarding whether hysteroscopy affects the prognosis of endometrial cancer by prompting cancer cell into intraperitoneal dissemination. Our purpose was to confirm whether hysteroscopy could be a risk factor of the tumor stage, recurrence and survival rate of endometrial cancer.
This multicenter retrospective study included all consecutive patients who had endometrial carcinoma diagnosed preoperatively with hysteroscopy and directed endometrial biopsy (HSC, group A) and dilatation and curettage (D&C, group B) between February 2014 and December 2018 at the Fujian Provincial, China. We compared the demographic feature, clinical characteristics and prognosis between the two groups.
A total of 429 patients were included in the study (Group A, = 77; Group B, = 352). There was no significant difference between their baseline characteristics [including age, BMI, histological type and International Federation of Gynecology and Obstetrics (FIGO) stage]. By comparing several pathological conditions that may affect prognosis, there were no significant differences between the two groups in the peritoneal cytology, depth of myometrial invasion, the positivity of lymph nodes, lymphovascular space invasion and paraaortic lymph node dissection. Finally, no significant difference was found between the two groups in overall survival (OS) ( = 0.189) or recurrence free survival (RFS) ( = 0.787).
Under certain inflation pressure and distension medium, hysteroscopic examination and lesion biopsy ensure the safety and have no adverse effects on prognosis compared to conventional curettage.
宫腔镜检查是诊断子宫内膜癌的一种有用方法。关于宫腔镜检查是否会通过促使癌细胞腹腔内播散而影响子宫内膜癌的预后存在争议。我们的目的是确定宫腔镜检查是否可能是子宫内膜癌肿瘤分期、复发和生存率的危险因素。
这项多中心回顾性研究纳入了2014年2月至2018年12月在中国福建省所有术前经宫腔镜检查及直视下子宫内膜活检(HSC,A组)和刮宫术(D&C,B组)诊断为子宫内膜癌的连续患者。我们比较了两组患者的人口统计学特征、临床特征和预后。
本研究共纳入429例患者(A组77例;B组352例)。两组患者的基线特征[包括年龄、体重指数、组织学类型和国际妇产科联盟(FIGO)分期]无显著差异。通过比较几种可能影响预后的病理情况,两组在腹腔细胞学、肌层浸润深度、淋巴结阳性率、淋巴血管间隙浸润和腹主动脉旁淋巴结清扫方面无显著差异。最后,两组在总生存期(OS)(P = 0.189)或无复发生存期(RFS)(P = 0.787)方面均未发现显著差异。
在一定的充气压力和膨胀介质下,与传统刮宫术相比,宫腔镜检查及病变活检可确保安全性且对预后无不良影响。