Lina Cao

Analysis of Lymph Node Metastasis and Risk Factors in 424 Patients with Low-Grade Endometrioid Endometrial Carcinomas

<p>Objectives: The objective of this study was to explore the lymph node metastasis (LNM) and related risk factors of low-grade endometrioid endometrial carcinomas (EECs) and analyse the efficacy of related risk factors in predicting LNM. Design: Data from 424 patients with low-grade EEC treated between January 2019 and June 2024 were retrospectively analysed, according to the International Federation of Gynecology and Obstetrics (FIGO) 2009. Methods: Univariate and multivariate logistic regression analyses were used to examine the factors associated with LNM. Receiver operating characteristic (ROC) curves were plotted to assess the predictive efficacy of independent risk factors for LNM. Results: The rate of LNM was 7.8% (33/424). Histological grade, tumour size, depth of myometrial invasion, cervical stromal invasion, lymphovascular space invasion (LVSI), microcystic, elongated, fragmented (MELF) pattern, carbohydrate antigen 125 (CA125), carbohydrate antigen 199, and human epididymis protein 4 were associated with LNM. However, only LVSI, MELF pattern, depth of myometrial invasion, and CA125 were identified as independent risk factors. The area under the ROC curve for CA125 and depth of myometrial invasion was 0.796 and 0.734, respectively. The optimal cut-off value for CA125 was 31.36 U/mL, with a maximum Youden index of 53.9%. Combining CA125 with depth of myometrial invasion improved diagnostic accuracy compared to either parameter alone. Limitations: This is a single-center retrospective study. Conclusions: LNM is more likely with independent risk factors. Combining CA125 and depth of myometrial invasion enhances diagnostic accuracy for LNM. This study provides valuable insights for predicting LNM risk in low-grade EEC patients and guiding stratified management. </p>

Analysis of Lymph Node Metastasis and Risk Factors in 975 Patients with FIGO 2009 Stage IA–IIA Cervical Cancer

Objectives: The objective of this study was to summarize the rate of lymph node metastasis (LNM) of patients with stage IA–IIA cervical cancer and further analyze its distribution characteristics and related risk factors. Design: This study is a retrospective analysis of clinical data about cervical cancer. Participants: According to the International Federation of Gynecology and Obstetrics (FIGO) 2009 staging standard, 975 patients with stage IA–IIA cervical cancer treated in our hospital from January 2010 to December 2018. Setting: This is a single-center study. Methods: The incidence and distribution of LNM were analyzed, and the influencing factors of cervical cancer LNM were analyzed using univariate and multivariate logistic regression. Results: In this study, the LNM rate was 14.8% (144/975), and a total of 20,288 lymph nodes were removed, among which 359 lymph nodes had metastasis. According to the number and frequency of metastatic lymph nodes in different regions, the metastatic rate was the highest in the external iliac regions. Univariate analysis showed that more than three pregnancies, tumor size >4 cm, gross type, FIGO stage, pathological type, positive lymphovascular space invasion (LVSI), deep cervical stromal invasion (outer half invasion), parametrial involvement, and uterine corpus invasion (UCI) were correlated with LNM (p < 0.05). Multivariate analysis showed that tumor lesion of >4 cm (odds ratio (OR) = 2.253, 95% confidence interval (CI): 1.486–3.416, p < 0.001), positive LVSI (OR = 5.353, 95% CI: 3.303–8.676, p < 0.001), deep cervical stromal invasion (OR = 3.461, 95% CI: 2.106–5.688, p < 0.001), and deep UCI (myometrial invasion ≥50%) (OR = 3.529, 95% CI: 1.321–9.427, p = 0.012) were independent risk factors for LNM. Limitations: Retrospective nature of the study and limitation to a single-center study are the limitations of the study. Conclusions: Patients with cervical cancer are more likely to have LNM with a tumor size of >4 cm, positive LVSI, deep cervical stromal invasion, or deep UCI. When these risk factors are present, the presence of LNM is possible, and attention should be paid. This study provides a certain reference value for predicting LNM risk for patients with early cervical cancer and for the stratified management of early cervical cancer treatment.