Endometrial Cancer and Vaginal Bleeding, February 14, 2001

Endometrial Cancer and Vaginal Bleeding, February 14, 2001

<!-- translated-chunk:46/63 -->

Commonly known as uterine corpus cancer, it is a major cause of vaginal bleeding in perimenopausal women and is easily misdiagnosed as menopausal metrorrhagia, leading to inappropriate treatment. It is a malignant tumor that poses a serious threat to the health of middle-aged and elderly women. It accounts for about 7% of all female cancers and approximately 30% of female genital tract cancers, with 80% of cases occurring around the age of 50. According to statistics from developed countries and major cities in China, it ranks first among gynecological malignancies. Diagnosis: Any woman around the age of 50 presenting with prolonged bleeding must be considered for this condition. Prolonged bleeding and uterine enlargement are the basic clinical features. ① Ultrasound can clearly visualize the size of the uterus and the thickness of the endometrium; if the endometrial thickness exceeds 5 mm, further scraping and examination of exfoliated cells should be performed. ② Exfoliative cytology is an important diagnostic tool for this disease; traditional cervical smears and posterior fornix aspirates have a positive rate of only about 50%. In recent years, sampling methods have been improved, including intrauterine suction, negative-pressure infusion, and direct intrauterine brushing. Direct brushing and smear collection combined with staged diagnostic curettage are even more ideal, achieving a diagnostic accuracy of 97%. ③ CT scans and hysteroscopy are usually more informative. Surgical treatment combined with radiotherapy and chemotherapy is the standard approach for treating this disease. Common risk factors for this disease include obesity, hypertension, diabetes, menstrual irregularities, early menarche, late menopause, lifelong infertility, multiparity, endometrial hyperplasia, and polycystic ovary syndrome.