Auxiliary examination items for endometrial cancer

There are many causes of endometrial cancer. People should be vigilant in their daily lives. They should pay attention to the symptoms of endometrial cancer and pay attention to good treatment methods. Endometrial cancer patients should understand the diagnosis. How should patients with endometrial cancer be examined?

1. Medical history: Endometrial cancer patients are mostly elderly women with delayed menopause or irregular menstruation. They are often infertile or have few parities, and are associated with obesity, hypertension, and diabetes. If they have irregular vaginal bleeding or foul-smelling discharge after menopause, they should be paid more attention. For young patients with irregular vaginal bleeding, the cause should also be carefully clarified, especially those who have been treated but have not been effective should also undergo curettage. Vaginal discharge and abdominal pain are already late symptoms.

2. Clinical examination: In the early stage, general gynecological examination often reveals nothing. The uterus is not large, the cervix is ​​smooth, and the appendages are normal. In the late stage of the disease, the uterus is larger than the corresponding age. Some patients may have bloody leucorrhea or rotten cancerous tissue on the finger cot after bimanual examination; some patients may have protruding polyp-like tumors at the cervical opening. However, endometrial cancer can coexist with uterine fibroids, so an enlarged uterus is not necessarily an advanced endometrial cancer.

3. Cytology examination: The diagnosis rate of vaginal cytology examination for endometrial cancer is lower than that for cervical cancer. The reasons are: ① Columnar epithelial cells do not often fall off; ② When the fallen cells reach the vagina through the cervical canal, they are often dissolved and denatured, making them difficult to identify; ③ Sometimes the cervical canal is narrow and closed, making it difficult for the fallen cells to reach the vagina. In order to improve the positive diagnosis rate, many scholars have improved the location and method of taking specimens. With the improvement of diagnostic technology, the positive diagnosis rate of endometrial cancer has also been greatly improved.

4. Ultrasound examination: Uterine ultrasound examination is of certain significance for endometrial cancer in terms of uterine cavity size, location, degree of myometrial invasion, whether the tumor penetrates the uterine serosa or involves the cervical canal, etc., and its diagnostic compliance rate is 79.3% to 81.82%. It has been reported that the accuracy of ultrasound is about 87% for patients over 45 years old and compared with hysteroscopy and biopsy. In addition, Xie Yanggui and others performed B-ultrasound examinations according to the UICC staging method, and compared with surgical exploration and pathology based on the tumor location, myometrial invasion, parauterine and adjacent organ involvement, and the staging compliance rate reached 92.9%. B-ultrasound examination does not cause creative and radioactive damage to patients, so it is one of the routine examinations for endometrial cancer. It has a certain reference value, especially in understanding myometrial invasion and clinical staging.

5. Diagnostic curettage: Curettage is an indispensable method for diagnosis. It is necessary not only to determine whether it is cancer, but also to determine the location of the cancer. If cervical adenocarcinoma is misdiagnosed as endometrial cancer and treated as a general hysterectomy, it is obviously inappropriate; if endometrial cancer is misdiagnosed as cervical adenocarcinoma, it is also inappropriate. However, microscopic examination cannot distinguish between cervical adenocarcinoma and endometrial cancer. Therefore, segmented diagnostic curettage is required. First, use a small curette to scrape the tissue inside the cervical canal, then enter the uterine cavity to scrape the tissues of the two sides of the uterine horns and the anterior and posterior walls of the uterine body, and bottle them separately with labels and send them for pathological examination. If there is resistance at the inner opening, the cervix can be slightly dilated to No. 5. Segmental curettage often goes too deep when scraping the cervical canal, mistaking the contents of the uterine cavity for cervical canal cancer; or endometrial cancer descends into the cervical canal, mistaking it for cervical canal cancer or uterine body cancer involving the cervical canal; or the original cervical canal cancer has too much cancer tissue, and when the small curette enters the uterine cavity, it brings in a little cervical cancer tissue and mistaking it for cervical cancer to have reached the uterine cavity. All these situations indicate that the lesions are already in a late stage, and they should be treated according to the scope of cervical cancer surgery.