Clinical Study Of Vimentin,ER,PR And P53 In Tiny Tissues For Endometrial Cancer Screening

ObjectiveThis study assessed the feasibility and diagnostic accuracy of disposable endometrial sampler collection of tiny tissues.The correlation of Vimentin,ER,PR and P53 with histopathological features was studied.Our study explores the clinical value of Vimentin,ER,PR and P53 in tiny tissues in screening for endometrial cancer.MethodThe preoperative tiny tissues of the patients were collected by a disposable negative pressure endometrial sampler,prepared as paraffin specimens for HE staining,and compared with the postoperative tissues of the patients using paired chi-square and KAPPA consistency tests to assess the feasibility of minimally invasive sampling and the accuracy of tiny tissue diagnosis.The correlation of Vimentin,ER,PR and P53 with the clinicopathological features of endometrial cancer patients was assessed by immunohistochemical SP method,using spearman correlation analysis and Fisher’s exact test.Result1.The diagnostic agreement rate between preoperative tiny tissues and postoperative tissues was 92.11%,and the difference in diagnostic accuracy between groups was not statistically significant（P=0.250）,with a degree of diagnostic agreement test of Kappa=0.83≥0.75.2.The diagnostic sensitivity and specificity of tiny tissue was 88.00% and100.00% respectively,with a positive predictive value of 100.00%,a negative predictive value of 81.25% and a Youden’s index（YI）of 0.88.3.The overall success rate for minimally invasive sampling was 95.00% and the overall satisfaction rate was 97.37%,with statistically significant differences in sampling success rates across endometrial thickness（p=0.000）.The difference in sampling success rate was not statistically significant（P > 0.05）for other clinical characteristics of the patients（age,menopausal status,BMI,history of pregnancy and delivery,history of curettage,history of surgery,history of vaginal bleeding and nature of endometrium）.4.Sampling duration was not affected by depth of the uterine cavity,volume of vaginal bleeding and by the presence or absence of a clamped cervix（p > 0.05）.Sampling for pain scoring was not interfered with by the patient’s age,timing of sampling,presence or absence of a clamped cervix,being menopausal or not,or the benignity or malignancy of the endometrium（P > 0.05）.5.Compared to morphological assessment alone（accuracy = 33.33%）,combined diagnosis improved the accuracy of tiny tissues at the high grade（accuracy = 66.67%）and was more precise for lower grade tissues than higher grade tissues（p=0.038）;combined diagnosis increased the accuracy of tiny tissues in tissue subtypes（non-EEC and EEC）by 50.00%.Conclusion1.As a method of sampling for preliminary screening of endometrial cancer,the endometrial sampler has clinical utility and the tissue collected has satisfactory diagnostic accuracy,sensitivity and negative predictive value.2.The endometrial sampler has the advantages of being easy to perform,minimally invasive,reproducible,avoids unnecessary cervical clamping,significantly relieves painful sampling,is safe and easily accepted by patients.3.Expression of Vimentin,ER,PR and P53 in tiny tissues of endometrial cancer helps to grade and stage the tissues precisely and may improve the accuracy of minimally invasive screening.