| Objectives: By detecting the expression levels of the antigens of Toposimerase II a (Topo II a) , nuclear-associated antigen-67 (Ki-67) and CD34, which responded the clinical features about growth, metabasis and recurrence of uterine sarcoma and we explored significance of pathogenetic condition's mortoring and of judging in prognosis of three sorts of tumor markers .Methods: Retrospective analysis was 48 patients of uterine sarcoma by tumorectomy in PLA general hospital. According to FIGO stage, Stage was I in 22, II in 12, III in 8 and IV in 6. Accoring to GOG's separate criteria of pathologic histology, 19 cases in LMS, 21 cases in ESS, 8 cases in MMMT. By immunohistochemistry (IHC) method, the expression levels of the antigens of Topo II a, Ki-67 and CD34 were detected.Results: The expressions of Topo II a and Ki-67 were divid(?)d into low label index (LI) group and high LI group according to label index. 27 patients were in low LI group of Topo II a and 21 ones in high LI group. 22 patients were in low LI group of Ki-67 and 26 ones in high LI. The expression of CD34 was divided into low MVD( microvessel density )group and high MVD group according to the median microvessel density being 46. They were 25 patients and 23 patients. The low value group and high value one of Topo II a, Ki-67, and CD34 were not correlated with patients'age, menarche age, gravidity and parity, condition of menstruation and menopause, being correlated with pathological category and staging.The survival time of low LI group of Topo II a, high LI group of Ki-67 and low MVD group of CD34 in different operational extents was different.Except that the survival time of low LI was more increasing than one of high LI of Ki-67 expression in OP-AT (P=0.021),the survival time of low value group and high value group in other therapic manners was not conspicuousdifferent. Over survival rate of high value group was lower than one of low value group noticeablly. Probability value was 0.0017, 0.0035 and 0.0039 by Log-Rank Test. The high value group of TopoIIa, Ki-67, and CD34 about recurring masses's bulk was bigger than low value group about one, which difference was significance in statistics(P=0.0053,0.0000 and 0.0000). The low value group of them about recurring time was longer than low value group about one, which difference was significance in statistics(P=0.0000 and 0.0002). The metastatic time of low value group was longer than one of high value group (P=0.0003,0.0000and 0.0000). They were positive linear correlations each other (r=0.9355, P=0.0000; r=0.8793, P=0.0002; r=0.9132, P=0.0001 ) .The result of multiple factor analysis of Cox Model was correlated with pathological category, pathological staging, bilateral oophorectomy and the expressions of Topo II a and CD34, being not correlated with other clinical and pathological features.Conclusions: CD34-MVD was specific marker in reflecting about invasive and metabasis behaviour in sarcoma of uterus. Topo II a could be specifice marker in reflecting cell proliferation state in uterine sarcoma. The result of multiple factor analysis was prognosis of uterine sarcoma which was relative to pathological category, pathological staging, bilateral oophorectomy and the expressions of Topo II a and CD34. Through understanding pathological category and staging, being or not being bilateral oophorectomy, associated with the expression levels of Topo II a and CD34, high risk patients were promoted to judging in prognosis, monitoring closely, formulating monitoring plans individually and finding repeating tumor early to the best extent, meanwhile, enhancing survival time of tumor patients and improve life quality.
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