Effects Of The Application Of Cup-shaped Uterine Manipulation On Vaginal Flushing Fluid Tumour Cells In Patients With Endometrial Cancer

Objective:To explore whether the use of cup-shaped uterine manipulation in laparoscopic surgery for stage I endometrial cancer increased the positive proportion of tumor cells in vaginal flushing fluid,which may provide a basis for subsequent observation of whether the use of cup-shaped uterine manipulation increased the probability of recurrence of vaginal stump cancer in future.Methods:Collecting the clinical data of patients who underwent laparoscopic surgery and intra-operative used of cup-shaped uterine manipulation in the first affiliated Hospital of Nanchang University due to stage I endometrial cancer from October 2020 to February 2022.Cytological and chromosome examination respectively were performed on the vaginal flushing fluid which were collected before and after the use of uterine manipulation.Cytological examination which indicated there were tumor cells were positive,and chromosome examination indicated that interphase nucleus marked atypia was positive.If either cytological examination or chromosome examination showed a positive result,the pathological result of vaginal flushing fluid was considered positive.The number of positive cases was counted and the results were analyzed.Results:A total of 32 patients were included in the study,of which cytological and chromosome examination of vaginal flushing fluid before surgery were all negative,and one of the patient’s vaginal flushing fluid after surgery was positive by cytological and chromosome examination,and the positive proportion of cytological and chromosome examination of vaginal flushing fluid after surgery was 3.1%.The result of cytological and chromosome examination of vaginal flushing fluid were not related to age,whether menopause,BMI,presence or absence of underlying diseases such as diabetes and high blood pressure,and whether combining uterine fibroids,lesions size,total uterine size,pathological type,histological grading,tumor markers,lymphy vascular space involvement,muscle layer infiltration,FIGO staging and ascites cytology,etc(P>0.05).Conclusions:The application of cup-shaped uterine manipulation in laparoscopic surgery for stage I endometrial cancer may did not increase the positive proportion of cytological and chromosome examination of tumor cells in vaginal flushing fluid,and the safety was relative safety,but the data of this study was limited and further sample size was needed to confirm the results.