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Preoperative and intraoperative assessment of myometrial invasion in patients with FIGO stage I non-endometrioid endometrial carcinoma-a large-scale, multi-center, and retrospective study

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作者：
Xiaohang Yang[1,2] * ; Jingjing Yin[1,2] ; Yu Fu[1,2] ; Yuanming Shen[3] ; Chuyao Zhang[4] ; Shuzhong Yao[5] ; Congjian Xu[6] ; Min Xia[7] ; Ge Lou[8] ; Jihong Liu[4] ; Bei Lin[9] ; Jianliu Wang[10] ; Weidong Zhao[11] ; Jieqing Zhang[12] ; Wenjun Cheng[13] ; Hongyan Guo[14] ; Ruixia Guo[15] ; Fengxia Xue[16] ; Xipeng Wang[17] ; Lili Han[18] ; Xiaomao Li[19] ; Ping Zhang[20] ; Jianguo Zhao[21,22,23] ; Wenting Li[1,2] ; Yingyu Dou[1,2] ; Zizhuo Wang[1,2] ; Jingbo Liu[1,2] ; Kezhen Li[1,2] ; Gang Chen[1,2] ; Chaoyang Sun[1,2] ; Pengming Sun[24] ; Weiguo Lu[3] ; Qin Yao[25] ;
单位： [1]Cancer Biology Research Center (Key Laboratory of the Ministry of Education),Tongji Hospital, Tongji Medical College, Huazhong University of Scienceand Technology, Wuhan, Hubei 430000, China [2]Department of Gynecologyand Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong Universityof Science and Technology, Wuhan, Hubei 430000, China [3]Women’s Hospital,School of Medicine, Zhejiang University, Hangzhou 310000, China [4]Departmentof Gynecologic Oncology, Sun Yat-Sen University Cancer Center, 651Dongfeng E Rd, Guangzhou 510060, China [5]Department of Obstetricsand Gynecology, The First Affiliated Hospital of Sun Yat-Sen University, No58 Zhong Shan ER Lu, Guangzhou 510080, China [6]Department of Gynecology,Obstetrics and Gynecology Hospital of Fudan University, Shanghai,China [7]Department of Gynecology and Obstetrics, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO 20 Yuhuangding East Road,Yantai, Shandong 264000, China [8]Department of Gynecology Oncology,Harbin Medical University Cancer Hospital, Harbin 150086, China [9]Departmentof Obstetrics and Gynecology, Shengjing Hospital Affiliated to ChinaMedical University, No.36, Sanhao Street, Heping District, Shenyang, Liaoning110004, China [10]Peking University People’s Hospital, Beijing 100044, China [11]The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine,University of Science and Technology of China, Hefei, Anhui 230001, China [12]Department of Gynecologic Oncology, Guangxi Medical University CancerHospital, 71 Hedi Road, Nanning, Guangxi 530021, China [13]The First AffiliatedHospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District,Nanjing, Jiangsu 210029, China [14]The Third Hospital of Peking University, 49North Garden Rd., Haidian District, Beijing, China [15]Department of Gynecologyand Obstetrics, The First Affiliated Hospital of Zhengzhou University, No.1,Jianshe East Road, Zhengzhou 450052, China [16]Department of Gynecologyand Obstetrics, Tianjin Medical University General Hospital, 154 AnshanDao, Heping District, Tianjin 300052, China [17]Department of Gynecologyand Obstetrics, XinHua Hospital, Shanghai JiaoTong University School of Medicine,Shanghai 200092, China [18]Department of Gynecology, People’s Hospitalof Xinjiang Uygur Autonomous Region, No.91 Tianchi Street, Tianshan District,Urumqi 830001, China [19]Department of Gynecology and Obstetrics, The ThirdAffiliated Hospital, Sun Yat-Sen University, No.600 Tianhe Road, Tianhe District,Guangzhou 510630, China [20]Department of Gynecology, The Second Hospitalof Shandong University, 247 Bei Yuan Street, Jinan, Shandong 250033, China [21]Department of Gynecologic Oncology, Tianjin Central Hospital of Gynecologyand Obstetrics, Affiliated Hospital of Nankai University, No.156, SanmaRoad, Nankai District, Tianjin 300100, China [22]Tianjin Clinical Research Centerfor Gynecology and Obstetrics, Affiliated Hospital of Nankai University, No.156,Sanma Road, Nankai District, Tianjin 300100, China [23]Branch of National ClinicalResearch Center for Gynecology and Obstetrics, Affiliated Hospital of NankaiUniversity, No.156, Sanma Road, Nankai District, Tianjin 300100, China [24]Fujian Provincial Women & Children’s Hospital, Fujian Provincial Maternity& Children Health Hospital, Fujian Medical University, Fuzhou, Fujian 350000,China [25]Department of Obstetrics and Gynecology, The Affiliated Hospitalof Qingdao University, 16 Jiangsu Road, Qingdao, Shandong 266003, China
出处：
DOI： 10.1186/s13000-023-01294-z
ISSN：

关键词： Non-endometrioid endometrial carcinoma Frozen sections Myometrial invasion Lymph node dissection Retrospective studies

摘要：
Myometrial invasion is a prognostic factor for lymph node metastases and decreased survival in non-endometrioid endometrial carcinoma patients. Herein, we explored the mode of myometrial invasion diagnosis in FIGO stage I non-endometrioid carcinoma and evaluated the differences in diagnostic efficiency among intraoperative frozen section (IFS), intraoperative gross examination (IGE), magnetic resonance imaging (MRI), and computed tomography (CT) in clinical practice. Finally, we suggested which test should be routinely performed.This was a historical cohort study nationwide with 30 centers in China between January 2000 and December 2019. Clinical data, including age, histology, method of myometrial invasion evaluation (MRI, CT, IGE, and IFS), and final diagnosis of postoperative paraffin sections, were collected from 490 non-endometrioid endometrial carcinoma (serous, clear cell, undifferentiated, mixed carcinoma, and carcinosarcoma) women in FIGO stage I.Among the 490 patients, 89.59% presented myometrial invasion. The methods reported for myometrial invasion assessment were IFS in 23.47%, IGE in 69.59%, MRI in 37.96%, and CT in 10.20% of cases. The highest concordance was detected between IFS and postoperative paraffin sections (Kappa = 0.631, accuracy = 93.04%), followed by IGE (Kappa = 0.303, accuracy = 82.40%), MRI (Kappa = 0.131, accuracy = 69.35%), and CT (Kappa = 0.118, accuracy = 50.00%). A stable diagnostic agreement between IFS and the final results was also found through the years (2000-2012: Kappa = 0.776; 2013-2014: Kappa = 0.625; 2015-2016: Kappa = 0.545; 2017-2019: Kappa = 0.652).In China, the assessment of myometrial invasion in non-endometrioid endometrial carcinoma is often performed via IGE, but the reliability is relatively low in contrast to IFS. In clinical practice, IFS is a reliable method that can help accurately assess myometrial invasion and intraoperative decision-making (lymph node dissection or not). Hence, it should be routinely performed in non-endometrioid endometrial carcinoma patients.© 2023. The Author(s).

基金：
The study and collection, analysis, and interpretation of data received the specific grant from The Nature and Science Foundation of China (82073259).
语种：
外文
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中科院(CAS)分区：
出版当年[2022]版：
大类 | 4 区 医学
小类 | 3 区 病理学
最新[2025]版：
大类 | 3 区 医学
小类 | 3 区 病理学
JCR分区：
出版当年[2021]版：
Q3 PATHOLOGY
最新[2023]版：
Q2 PATHOLOGY

影响因子： 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

第一作者：
第一作者单位： [1]Cancer Biology Research Center (Key Laboratory of the Ministry of Education),Tongji Hospital, Tongji Medical College, Huazhong University of Scienceand Technology, Wuhan, Hubei 430000, China [2]Department of Gynecologyand Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong Universityof Science and Technology, Wuhan, Hubei 430000, China
通讯作者：
推荐引用方式(GB/T 7714)：
Xiaohang Yang,Jingjing Yin,Yu Fu,et al.Preoperative and intraoperative assessment of myometrial invasion in patients with FIGO stage I non-endometrioid endometrial carcinoma-a large-scale, multi-center, and retrospective study[J].DIAGNOSTIC PATHOLOGY.2023,18(1):8.doi:10.1186/s13000-023-01294-z.
APA：
Xiaohang Yang,Jingjing Yin,Yu Fu,Yuanming Shen,Chuyao Zhang...&Qin Yao.(2023).Preoperative and intraoperative assessment of myometrial invasion in patients with FIGO stage I non-endometrioid endometrial carcinoma-a large-scale, multi-center, and retrospective study.DIAGNOSTIC PATHOLOGY,18,(1)
MLA：
Xiaohang Yang,et al."Preoperative and intraoperative assessment of myometrial invasion in patients with FIGO stage I non-endometrioid endometrial carcinoma-a large-scale, multi-center, and retrospective study".DIAGNOSTIC PATHOLOGY 18..1(2023)

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