Effect of preoperative indicators on the risk of lymph-vascular space invasion in endometrial carcinoma

Abstract:

Objective To investigate the clinicopathological features of patients with endometrial carcinoma（EC） affecting lymph-vascular space invasion（LVSI）， and to identify independent risk factors.Methods A retrospective analysis was performed for the clinicopathological data of 196 patients with EC who underwent treatment in Affiliated Hospital of Zunyi Medical University and The Second Affiliated Hospital of Zunyi Medical University from January 2019 to August 2022. The risk factors evaluated included preoperative carbohydrate antigen 125（CA125），preoperative carbohydrate antigen 199，pathological type，histological grade，tumor size，depth of myometrial invasion，neutrophil-to-lymphocyte ratio，expression of mismatch repair proteins，Ki67，and P53. The chi-square test and the logistic regression analysis were used to determine the risk factors for LVSI in EC.Results Among the 196 patients with EC，23 were positive for LVSI，with a positive rate of 11.7%. The multivariate analysis showed that preoperative CA125≥35 U/mL[odds ratio（OR）=3.539，95%CI=1.252-10.008，P<0.05]，myometrial invasion depth≥1/2（OR=3.893，95%CI=1.323-11.451，P<0.05），and poor differentiation（OR=3.206， 95%CI=1.030-9.978，P<0.05） were independent risk factors for LVSI in patients with EC.Conclusion Preoperative CA125≥35 U/mL，myeloid invasion depth≥1/2，and poor differentiation（histologic grade） are independent risk factors for LVSI in patients with EC，and the emphasis on preoperative predictive factors combined with the assessment of LVSI status in patients with EC can help surgeons to further evaluate lymph node involvement and prognosis and better select the surgical approach， so as to realize individualized precise treatment.