Evaluation before fertility-sparing treatment for endometrial cancer

Before undergoing fertility-preserving treatment, patients with endometrial cancer must undergo a comprehensive evaluation. The evaluation methods mainly include taking medical history, diagnostic curettage, estrogen and progesterone receptor testing, imaging examinations, CA125 testing, laparoscopy, etc.

1. Ask about gynecological history and family history: Understanding the patient's gynecological history and family history will help conduct a comprehensive physical examination and assess reproductive function.

2. Diagnostic curettage: Diagnostic curettage should be performed for patients with endometrial cancer who retain their uterus to determine the cell type and histological grade.

3. Determination of estrogen and progesterone receptors: While conducting histological examination of endometrial tissue, estrogen and progesterone receptors should also be determined. Highly differentiated endometrial cancer with positive estrogen and progesterone receptors responds well to progesterone therapy.

4. Imaging examination: Imaging examination can help improve the accuracy of clinical staging. Before fertility-preserving treatment, imaging examinations such as B-ultrasound, CT and MRI should be performed to evaluate myometrial invasion (excluding deep myometrial involvement), cervical involvement and distant metastasis.

5. CA125 determination: Serum CA125 can be used as an important indicator for the diagnosis and prognosis of endometrial cancer. It can be combined with vaginal ultrasound to increase the detection rate of adnexal involvement to exclude tumor metastasis.

6. Laparoscopy: Laparoscopy mainly includes peritoneal washing fluid cytology examination, pelvic lymph node sampling and assessment of adnexa involvement.