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Hysteroscopy combined dilatation and curettage, serum CA125 and CA19-9 play an important role in preserving fertility or endocrine function for early-stage endometrial cancer patients.

OBJECTIVE
The aim of the study was to evaluate the role of hysteroscopy combined dilatation and curettage (D&C), serum CA125 and CA19-9 in endometrial cancer (EC) patients who desire to preserve fertility or endocrine function.


MATERIALS AND METHODS
This retrospective study included a total of 622 patients with EC between January 2006 and December 2014. The consistency of preoperative and postoperative histopathological findings were compared in patients who underwent D&C with or without hysteroscopy. The incidence of positive peritoneal cytology was also compared to assess the safety of hysteroscopy. Receiver operating characteristic (ROC) curve was used to evaluate the role of preoperative serum CA125 and CA19-9 in predicting extrauterine metastasis.


RESULTS
In 151 patients who underwent hysteroscopy combined D&C, the consistency of pre- and postoperative pathology was higher than the remaining 447 patients who underwent classical D&C alone (83.44% vs. 74.94%,p < 0.05) and there was no significant difference in the incidence of positive peritoneal cytology between the two groups (2.64% vs. 2.73%, p > 0.05). ROC curve analysis results showed the CA125 serum level of 31.75 U/ml and CA19-9 serum level of 35.40 U/ml were the best cutoff to predict extrauterine metastasis in endometrial cancer, with 66.7% sensitivity, 83% specificity, and 61.9% sensitivity and 84.9% of specificity, respectively.


CONCLUSIONS
Hysteroscopy combined D&C should be recommended for early-stage EC patients who desire to preserve fertility or endocrine function, and the preoperative serum levels of CA125 and CA19-9 were powerful in predicting tumor stage in these patients.