Qiufang Bao,1,2 Liping Zheng,1 Linliang Hong3,4 

1Department of Obstetrics and Gynecology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, 350005, People’s Republic of China; 2Department of Obstetrics and Gynecology, The First Clinical College of Fujian Medical University, Fuzhou, Fujian Province, 350005, People’s Republic of China; 3Department of Pediatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, 350005, People’s Republic of China; 4Department of Pediatrics, the First Clinical College of Fujian Medical University, Fuzhou, Fujian Province, 350005, People’s Republic of China

Correspondence: Linliang Hong, Department of Pediatrics, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Fuzhou, Fujian, 350005, People’s Republic of China, Tel +86-18850376822, Email hong020ll@163.com

Objective: Endometrial cancer (EC) is the major female malignant tumor in developed countries. MRI is frequently applied in gynecologic malignancies. We probed the diagnostic value of MRI for pelvic lymph node extracapsular invasion (PLNEI) in early-stage EC patients.
Methods: Totally 142 early-stage EC patients were retrospectively enrolled and divided into the PLNEInegative/PLNEIpositive groups. Differences in MRI parameters [volume index (VI), total tumor volume (TTV), tumor volume ratio (TVR), mean apparent diffusion coefficient (ADCmean)] were analyzed. Early-stage EC patients with PLNEI were categorized into the high/low VI, TTV, TVR, ADCmean groups. The relationships of VI, TTV, TVR and ADCmean with clinicopathological characteristics were analyzed. Independent influencing factors for PLNEI, and the diagnostic value of VI, TTV, TVR and ADCmean for PLNEI were analyzed by logistic univariate/multivariate regression and receiver operating characteristic curve, with differences in areas under the curves compared by Delong test.
Results: There were significant differences in the histological type, histological grade, myometrial invasion depth, LVSI positive detection, LVSI type, cervical involvement, and CA125 level between the two groups. The VI, TTV and TVR values were elevated and ADCmean value was reduced in patients with PLNEI, which were associated with the clinicopathological characteristics of early-stage EC patients. The CA125 level, VI, TTV, TVR and ADCmean were independent influencing factors for PLNEI, showing high diagnostic value for PLNEI.
Conclusion: VI, TTV, TVR, and ADCmean had high diagnostic value for PLNEI in early-stage EC patients. MRI was a good method to detect PLNEI in EC patients.

Keywords: endometrial carcinoma, magnetic resonance imaging, pelvic lymph node extracapsular invasion, mean apparent diffusion coefficient