Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature: prospective multicenter study

作者：Epstein E^*; Fischerova D; Valentin L; Testa A C; Franchi D; Sladkevicius P; Fruehauf F; Lindqvist P G; Mascilini F; Fruscio R; Haak L A; Opolskiene G; Pascual M A; Alcazar J L; Chiappa V; Guerriero S; Carlson J W; Van Hol**eke C; Leone F P Giuseppe; De Moor B; Bourne T; van Calster B; Installe A; Timmerman D; Verbakel J Y; Van den Bosch T

来源：Ultrasound in Obstetrics and Gynecology, 2018, 51(6): 818-828.

DOI：10.1002/uog.18909

• diagnostic imaging
• Doppler
• endometrial neoplasm
• neoplasm staging
• ultrasonography

Objective To describe the sonographic features of endometrial cancer in relation to tumor stage, grade and histological type, using the International Endometrial Tumor Analysis (IETA) terminology.
Methods This was a prospective multicenter study of 1714 women with biopsy-confirmed endometrial cancer undergoing standardized transvaginal grayscale and Doppler ultrasound examination according to the IETA study protocol, by experienced ultrasound examiners using high-end ultrasound equipment. Clinical and sonographic data were entered into a web-based database. We assessed how strongly sonographic characteristics, according to IETA, were associated with outcome at hysterectomy, i.e. tumor stage, grade and histological type, using univariable logistic regression and the c-statistic.
Results In total, 1538 women were included in the final analysis. Median age was 65 (range, 27-98) years, median body mass index was 28.4 (range 16-67) kg/m(2), 1377 (89.5%) women were postmenopausal and 1296 (84.3%) reported abnormal vaginal bleeding. Grayscale and color Doppler features varied according to grade and stage of tumor. High-risk tumors, compared with low-risk tumors, were less likely to have regular endometrial-myometrial junction (difference of -23%; 95% CI, -27 to -18%), were larger (mean endometrial thickness; difference of +9%; 95% CI, +8 to +11%), and were more likely to have non-uniform echogenicity (difference of +7%; 95% CI, +1 to +13%), a multiple, multifocal vessel pattern (difference of +21%; 95% CI, +16 to +26%) and a moderate or high color score (difference of +22%; 95% CI, +18 to +27%).
Conclusion Grayscale and color Doppler sonographic features are associated with grade and stage of tumor, and differ between high- and low-risk endometrial cancer.

• 出版日期2018-6