Comparative study of transvaginal ultrasonography and CA 125 in the preoperative evaluation of myometrial invasion in endometrial carcinoma

Alcázar, Juan Luis; Jurado, M.; López-Garcı́a, Guillermo

doi:10.1046/j.1469-0705.1999.14030210.x

Cited by 17 publications

(17 citation statements)

References 36 publications

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“…Some groups (13,(21)(22)(23)(24)(25)(26) have assessed the role of transvaginal twodimensional (2D) ultrasonography (US) for the assessment of myometrial invasion with considerable variation in methods and results. This could be explained by the fact that this technique is highly operator dependent because it is mainly based on the subjective impression of the examiner.…”

mentioning

confidence: 99%

Assessing Myometrial Infiltration by Endometrial Cancer: Uterine Virtual Navigation with Three-dimensional US

Alcázar

Galván²,

Albela³

et al. 2009

Radiology

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Purpose:To describe and analyze the diagnostic performance of uterine virtual navigation with three-dimensional (3D) ultrasonography (US) for the assessment of the depth of myometrial infiltration by endometrial cancer. Materials and Methods:Institutional review board approval was obtained; patients gave oral informed consent. Women with endometrial cancer were evaluated by using 3D US prior to surgical staging. A 3D volume of the whole uterus was obtained and analyzed by using software. Virtual navigation through three orthogonal planes was performed to identify the shortest myometrial tumor-free distance to serosa (TDS) by analyzing the lateral, anterior, posterior, and fundal portions of the myometrium. Myometrial infiltration was also assessed by subjective impression of an examiner. Histologic findings of myometrial infiltration and TDS measured by a pathologist were used as the reference standard. A receiver operating characteristic curve was plotted to identify the best cutoff for TDS for identifying myometrial infiltration of 50% or more. Results:Ninety-six women (mean age, 61.8 years; range, 31-86 years) with endometrial cancer were included in the study. At histologic analysis, myometrial invasion was found to be less than 50% in 69 (72%) cases and 50% or more in 27 (28%) cases. TDS measured with US was positively correlated with histologically measured TDS (r ϭ 0.649; 95% confidence interval: 0.52, 0.76). The best cutoff for USmeasured TDS was 9.0 mm (sensitivity, 100%; specificity, 61%; negative predictive value, 100%; positive predictive value, 50%). Subjective impression had a sensitivity of 92.6%, a specificity of 82.3%, a negative predictive value of 96.6%, and a positive predictive value of 67.7%. Conclusion:Uterine virtual navigation with 3D US is a reliable method for the assessment of myometrial infiltration in patients with endometrial cancer.

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confidence: 99%

Assessing Myometrial Infiltration by Endometrial Cancer: Uterine Virtual Navigation with Three-dimensional US

Alcázar

Galván²,

Albela³

et al. 2009

Radiology

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“…As a conclusion, in order to prevent from the noted medical errors it is suggested to use combined method including immunoassay, Doppler colorful ultrasonography [5] and transvaginal ultrasonography [6]. Immunoassay method in turn should be consisted of dual assaying CA-125 and CEA, because it might be helpful to distinguish endometriosis (stage 3 and 4) from ovarian cancer.…”

Section: Resultsmentioning

confidence: 99%

“…Other than endometriosis, other cases such as septicemia secondary to E. coli also can result in up-regulation of CA-125 [1]. Also in endometrial carcinoma which is one of the most commonplace malignancies in women we have up-regulation of CA-125 [6].…”

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confidence: 99%

Overlaps of CA-125 Bio Marker As a kind of Medical Error in Women's Complications: A Cross Sectional Study in Korramabad (west of Iran)

Ahmadi¹,

Hasanvand²,

Baharvand³

et al. 2016

IJIMS

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“…In their study, Alcazer JL et al [25] evaluated the relationship between serum CA 125 levels and myometrial invasion depth in 50 endometrial cancer patients and found the CA 125 levels to be higher in patients with deep invasion. Choi et al [26] reported the preoperative CA 125 level to be significantly associated with deep myometrial invasion in 42 endometrial cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Endometrial and Ovarian Cancer with MR Imaging Importance of Serum HE4 and CA 125 Levels in the Extent of Disease at Evaluation

Yılmaz

Kumtepe

2017

Eurasian J Med

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Objective: Currently, no clinically useful tumor marker is available for primary diagnosis in endometrial cancer. Human epididymis protein-4 (HE-4) has high sensitivity and specificity as a tumor marker. Further, HE-4 has been shown to be elevated in early stage endometrial cancer and is more sensitive than CA 125. In our study, CA 125 and HE-4 reputation as a tumor marker for diagnosis of ovarian and endometrial cancer with the use of both the availability and affect the way we investigated the rate of diagnosis. Materials and Methods:Here 20 patients with ovarian cancer, 26 patients with endometrial cancer, which had been histologically diagnosed, and 40 healthy volunteers were included. Peripheral blood samples were taken and serum CA 125 and HE-4 were tested.Results: Serum CA 125 and HE-4 levels in patients with ovarian cancer were found to be significantly higher than those in healthy volunteers (p<0.05). Receiver-operating characteristic (ROC) analysis was performed. For patients with ovarian cancer and healthy controls, the CA 125 (0.83) and HE-4 (0.84) levels showed increased sensitivity (95%). There was no significant difference in the CA 125 levels in patients with endometrial cancer and healthy controls (p>0.05), whereas HE-4 levels were found to be higher in patients with endometrial cancer than in healthy controls (p<0.05). ROC analysis was performed. For endometrial cancer patients and healthy controls, the CA 125 (0.59) and HE-4 (0.63) levels showed increased sensitivity (88.5%). Conclusion:In ovarian and endometrial cancer, wherein early diagnosis is the most important factor for prognosis and survival, HE-4 is a new serum tumor marker that can be used with the aim of noninvasive diagnoses. For early diagnosis, the concomitant use of CA 125 and HE-4 is more effective and reliable than using either of them alone.Keywords: Ovary, endometrium, cancer, diagnosis, tumor marker ÖZ Amaç: CA 125 erken evre over kanserlerinin sadece %50'sinde yükselir. Endometrium kanserinde klinik pratikte rutin olarak kullanılan tümör marker yoktur. Human epididimis protein-4 (HE-4) over kanserlerinde yüksek sensitivite ve spesifiteye sahiptir. Endometrial kanserde CA 125 den daha sensitif olduğu ve erken evrede yükseldiği gösterilmiştir. Çalışmamızda CA 125 ve HE-4'ün over ve endometrium kanserinde tümör markerı olarak kullanılabilirliğini ve ikisinin birlikte kullanımın teşhis oranını ne şekilde etkileyeceğini araştırdık.Gereç ve Yöntem: Çalışmamıza histopatolojik olarak tanısı konulan 20 over kanseri, 26 endometrium kanseri hasta ile jinekolojik problemi olmayan 40 sağlıklı gönüllü dahil edilmiştir. MR görüntülemesiyle FIGO sistemine göre evreleri belirlendi. Hastalardan preoperatif olarak ve sağlıklı gönüllülerden periferik kan alınarak serum CA 125 ve HE-4 düzeyleri çalışıldı.Bulgular: Over kanseri hastalarının serum CA 125 ve HE-4 düzeyleri sağlıklı kontrollerinkinden anlamlı yüksek bulundu (p<0,05). ROC (Receiver Operatör Characteristic) analizi uygulandığında over kanseri hastalarında CA 125 (0,83) ve HE...

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Comparative study of transvaginal ultrasonography and CA 125 in the preoperative evaluation of myometrial invasion in endometrial carcinoma

Cited by 17 publications

References 36 publications

Assessing Myometrial Infiltration by Endometrial Cancer: Uterine Virtual Navigation with Three-dimensional US

Assessing Myometrial Infiltration by Endometrial Cancer: Uterine Virtual Navigation with Three-dimensional US

Overlaps of CA-125 Bio Marker As a kind of Medical Error in Women's Complications: A Cross Sectional Study in Korramabad (west of Iran)

Endometrial and Ovarian Cancer with MR Imaging Importance of Serum HE4 and CA 125 Levels in the Extent of Disease at Evaluation

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