Journal Article

Preoperative clinical characteristics scoring system for differentiating uterine leiomyosarcoma from fibroid

Yu, Xin, Zhu, Lan, Fan, Qingbo, Shi, Honghui, Lang, Jinghe, Zhang, Guorui

2020

Overview

Background Morcellation may lead to intraperitoneal spread of tumor cells, thus making prognosis of undiagnosed uterine leiomyosarcoma (ULMS) worse. However, preoperative diagnosis of ULMS remains challenging. This study aimed to design a preoperative clinical characteristics scoring system for differentiating ULMS from uterine fibroid. Methods This study enrolled 45 ULMS patients and 180 uterine fibroid patients in Peking Union Medical College Hospital from January 2013 to December 2018. Results The incidence of occult ULMS was 0.59% (95% CI, 0.39–0.71%). Age ≥ 40 years old (OR 2.826, 95%CI 1.326–5.461), tumor size ≥7 cm (OR 6.930, 95% CI 2.872–16.724), neutrophil-to-lymphocyte ratio (NLR) ≥ 2.8 (OR 3.032, 95%CI 1.288–7.13), number of platelet ≥298 × 10 9 /L (OR 3.688, 95%CI 1.452–9.266) and lactate dehydrogenase (LDH) ≥ 193 U/L (OR 6.479, 95%CI 2.658–15.792) were independent predictors of ULMS. A preoperative clinical characteristics scoring system was designed based on OR values, with a total score of 7 points. Tumor size ≥7 cm, LDH ≥ 193 U/L were assigned 2 points, while age ≥ 40 years old, NLR ≥ 2.8 and number of platelet ≥298 × 10 9 /L were assigned 1 point. Score ≥ 4 points was a useful predictor in diagnosing ULMS from fibroid (sensitivity 0.800, specificity 0.778). Conclusions The incidence of occult ULMS was low. Age ≥ 40 years old, tumor size ≥7 cm, LDH ≥ 193 U/L, NLR ≥ 2.8 and number of platelet ≥298 × 10 9 /L were independent predictors of ULMS. The preoperative clinical characteristics scoring system could be helpful in preoperative diagnosis of occult ULMS.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Age / Asymptomatic Diseases - epidemiology / Biomedical and Life Sciences / Biomedicine / cancer imaging / Cancer Research / Diagnosis / Diagnosis, Differential / Feasibility Studies / Female / Fibroid / Fibroids / Gynecology / Health Promotion and Disease Prevention / Hospitals / Humans / Hysterectomy / Incidence / interventional therapeutics / L-Lactate dehydrogenase / L-Lactate Dehydrogenase - blood / Laboratories / Lactic acid / Leiomyoma - blood / Leiomyoma - diagnosis / Leiomyoma - surgery / Leiomyosarcoma / Leiomyosarcoma - blood / Leiomyosarcoma - diagnosis / Leiomyosarcoma - epidemiology / Leiomyosarcoma - surgery / Lymphocyte Count / Lymphocytes / Medical prognosis / Medical research / Medical schools / Medicine/Public Health / Middle Aged / Neutrophils / Oncology / Patients / Platelet Count / Platelets / Preoperative Period / Prognosis / Regression analysis / Research Article / Retrospective Studies / Risk factors / Sarcoma / Surgery / Surgical Oncology / Tumor cells / Tumors / Ultrasonic imaging / Uterine cancer / Uterine leiomyosarcoma / Uterine Neoplasms - blood / Uterine Neoplasms - diagnosis / Uterine Neoplasms - epidemiology / Uterine Neoplasms - surgery / Uterus