EndometrialEndometrialCarcinomaCarcinomaWomenWomen’’sHospital,SchoolofMedicine,ZhejianguniversitysHospital,SchoolofMedicine,ZhejianguniversityGeneralConsiderationsGeneralConsiderations•EndometrialcarcinomaisoneofthemostEndometrialcarcinomaisoneofthemostthreecommonpelvicgenitalcancerinwothreecommonpelvicgenitalcancerinwomen.men.•Itismalignantepithelioidtumor.Itismalignantepithelioidtumor.•TheincidenceofendometrialcancerhasTheincidenceofendometrialcancerhasnowraised.nowraised.•ThepeakincidenceofonsetisintheageThepeakincidenceofonsetisintheage58-61years.58-61years.EtiologyEtiologyEtiologyofendometrialcarcinomamayinvoEtiologyofendometrialcarcinomamayinvolvetwomechanismslvetwomechanisms•estrogen-dependentestrogen-dependent•estrogen-independentcertainestrogen-independentcertainPathologyPathology•EndometrioidadenocarcinomaEndometrioidadenocarcinoma•SerousadenocarcinomaSerousadenocarcinoma•ClearcellcarcinomasClearcellcarcinomas•MucusadenocarcinomaMucusadenocarcinoma•OthersOthersMETASTASISMETASTASIS•DirectinvasionDirectinvasion•LymphaticmetastasisLymphaticmetastasis•Vascularmetastasis(advancedstage)Vascularmetastasis(advancedstage)SYMPTOMSSYMPTOMS•mostlyofthediseaseoccursintheeldermostlyofthediseaseoccursintheelderpatients,thereisnosymptomsattheverpatients,thereisnosymptomsattheveryearlystageanditisonlydiscoveredbyearlystageanditisonlydiscoveredbyexamine.yexamine.•abnormalvaginalbleedingabnormalvaginalbleeding•vaginalfluiding.vaginalfluiding.•pelvicpainpelvicpain•weakness,weightloss,andanemiaweakness,weightloss,andanemiaPhysicalexaminationisusuallyPhysicalexaminationisusuallyunremarkableattheveryearlystage.theunremarkableattheveryearlystage.theuterusmaybeenlargedandthemassmayuterusmaybeenlargedandthemassmaymoveoutofthecavityintheadvancedmoveoutofthecavityintheadvancedcases.Somesignsofmetastasiscanbecases.SomesignsofmetastasiscanbefoundofthelatestagesofthediseasefoundofthelatestagesofthediseaseSIGNSSIGNSDiagnosisDiagnosis•HistoryHistory：：clinicalrepresentationandhighriskclinicalrepresentationandhighriskfactor,familyhistoryfactor,familyhistory–vaginalbleedingvaginalbleeding–High-riskfactorsHigh-riskfactors–LongtermuseofE2,TAMLongtermuseofE2,TAM–FamilyhistoryofbreastcancerandendometrialFamilyhistoryofbreastcancerandendometrialcarcinomascarcinomas•SignsSignsSpecialExaminationsSpecialExaminations•FractionalcurettageFractionalcurettage•EndometrialbiopsyEndometrialbiopsy•EndocervicalcurettageEndocervicalcurettageDiagnoseofendometrialcarcinomaneedstheDiagnoseofendometrialcarcinomaneedsthepathologicresultspathologicresults•EndometrialcytologyexamarealsousedinsoEndometrialcytologyexamarealsousedinsomepatients.mepatients.•UltrasonographycanbehelpfulindecidingcliniUltrasonographycanbehelpfulindecidingclinicalstaging,Inpostmenopausalwomen,4mmiscalstaging,Inpostmenopausalwomen,4mmisthecutoffforanormalunilateralendometrialstrthecutoffforanormalunilateralendometrialstripe.ipe.•Thefunctionofcavityscopyiscontroversy.Thefunctionofcavityscopyiscontroversy.•MRIandCTappeartoimprovetheaccuracyofMRIandCTappeartoimprovetheaccuracyofclinicalstagingandisparticularlyhelpfulinidentclinicalstagingandisparticularlyhelpfulinidentifyingmyometrialinvasion.ifyingmyometrialinvasion.•SerumCA-125,awell-establishedtumormarkerSerumCA-125,awell-establishedtumormarkercanalsobeusefulf...
