The predictive values of preoperative endometrial thickness measurement and CA 125 levels in the evaluation of myometrial invasion in endometrial cancers

Objective: With regards to early-stage endometrial cancers, the inclusion of lymph node dissection in hysterectomy must be discussed. The identification of preoperative myometrial invasion is of importance in terms of reducing the rates of morbidity and mortality. This study aimed to investigate the predictive value of preoperative endometrial thickness measurement and CA 125 value in identifying myometrial invasion. Materials and Methods: Of the patients who received a pathological diagnosis of endometrial cancer and operated on in Haydarpaşa Numune Training and Research Hospital between the period 2010-2015; 131 patients whose preoperative endometrial thickness measurements as well as CA125 levels were studied were incorporated into this study. The association of preoperative endometrial thickness measurements and CA 125 levels on myometrial invasion were explored. Results: CA 125 levels increased in Stage II and above. When CA 125 value is > 35 mIU/ml, the predictive value of myometrial invasion is 35% sensitive and 80% specific in all the histological types and grades. This value in endometrioid cancers is 45% sensitive and 88% specific. The preoperative endometrial thickness measurement (16.5 mm) had a 55% sensitivity and a 50% specificity in determining myometrial invasion in all the histological and grade types. However, in endometrioid and Grade 1-2 cancers, there was 16-mm cut-off point, with a 60% sensitivity and 70% specificity. Conclusion: CA 125 is not a sensitive but a specific test for the assesment of myometrial invasion. The measurement of endometrial thickness may be valuable in Grade 1-2 endometroid cancers. Although predictive power of both test is not high, they may be used in surgical planning.

Endometrial cancer; Lymph node dissection, CA 125; Myometrial invasion

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