Maehana Tomoka, Kawahara Naoki, Kamibayashi Junya, Matsuoka Motoki, Waki Keita, Kawaguchi Ryuji, Kimura Fuminori
Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo, Kashihara, 634-8522, Nara, Japan.
BMC Womens Health. 2024 Dec 30;24(1):671. doi: 10.1186/s12905-024-03528-8.
Recently, there have been an increasing number of reports on the association between inflammatory markers and the prognosis of malignant tumors. However, the current inflammatory indicators have limited accuracy. We aimed to develop a new scoring system for predicting endometrial cancer recurrence using inflammatory markers, tumor markers, and histological diagnoses.
Patients with primary, previously untreated, and suspected endometrial cancer who underwent surgery at the Nara Medical University Hospital between January 2007 and December 2020 were included and followed up until March 2024. Items were divided into positive and negative using scores based on cutoff values and placed into the new scoring system, the endometrial tumor-related (ETR) score.
We found that positive postoperative histological examination of lymph node metastasis and myometrial invasion, high levels of carcinoembryonic antigen and D-dimer in preoperative blood tests, and a large difference in preoperative and postoperative white blood cell counts were significantly associated with recurrence. The sensitivity and specificity of recurrence prediction using the ETR score were not inferior to those using the International Federation of Gynecology and Obstetrics staging system, which is considered the best prognostic factor for survival.
The ETR score is a significant prognostic marker of recurrence in patients who have undergone staging surgery, with complete surgical tumor removal.
最近，关于炎症标志物与恶性肿瘤预后之间关联的报道越来越多。然而，目前的炎症指标准确性有限。我们旨在开发一种新的评分系统，利用炎症标志物、肿瘤标志物和组织学诊断来预测子宫内膜癌复发。
纳入2007年1月至2020年12月期间在奈良医科大学医院接受手术的原发性、未经治疗且疑似子宫内膜癌的患者，并随访至2024年3月。根据临界值将各项指标用分数分为阳性和阴性，并纳入新的评分系统——子宫内膜肿瘤相关（ETR）评分。
我们发现，术后淋巴结转移和肌层浸润的组织学检查呈阳性、术前血液检查中癌胚抗原和D - 二聚体水平较高，以及术前和术后白细胞计数差异较大与复发显著相关。使用ETR评分进行复发预测的敏感性和特异性不低于使用国际妇产科联盟分期系统，而该分期系统被认为是生存的最佳预后因素。
ETR评分是接受分期手术且肿瘤完全切除的患者复发的重要预后标志物。
