Clinical Value of Vaginal Color Doppler Ultrasound Parameters Combined with Tumor Markers in the Pathological Grading and Prognostic Evaluation of Endometrial Cancer

LIU Tianying; NIU Hua; DUAN Xin; ZHANG Gai; XIE Qing; ZHENG Xiaoye; SU Shasha

doi:10.3639/j.issn.2095-3097.2025.05.010

Abstract：Objective To investigate the clinical value of transvaginal color Doppler ultrasound(hereinafter referred to as transvaginal ultrasound)parameters combined with the tumor marker carbohydrate antigen 125(CA125)in the pathological grading and prognostic evaluation of endometrial cancer.Methods A total of 112 patients with endometrial cancer admitted to Xidian Group Hospital from January 2020 to September 2023 were selected as the endometrial cancer group,and 115 pa-tients with endometrial hyperplasia during the same period were selected as the control group.All enrolled subjects underwent color Doppler ultrasound examination,and the peak systolic velocity(PSV),pulsatility index(PI),and resistance index(RI)of the lesion were measured.Serum CA125 levels were also detected.The differences in ultrasound parameters and CA125 between the two groups were compared,and the value of the above parameters in evaluating the pathological grading and prognosis of endometrial cancer was analyzed.Results The endometrial cancer group had significantly higher PSV and CA125 levels than the control group,while RI and PI were significantly lower(P<0.05).The high-grade endometrial cancer group exhibited higher PSV and CA125 levels than the low-grade group,with lower RI and PI(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the combination of PSV,RI,PI,and CA125 for assessing pathological grading of endometrial cancer yield-ed an AUC of 0.910,which was higher than that of PSV(0.805),RI(0.820),PI(0.815),or CA125(0.802)alone(Z=6.885,8.542,7.842,6.652;P<0.001).The poor prognosis group had a higher proportion of FIGO stageⅢ-Ⅳ,pathological grade G3,PSV,and CA125 levels compared to the good prognosis group,while RI and PI were significantly lower(P<0.05).Multivariate logistic re-gression analysis revealed that FIGO stageⅢ-Ⅳ(OR=3.717),pathological grade G3(OR=1.744),PSV≥20.33 cm/s(OR=2.347),RI<0.35(OR=3.043),PI<0.40(OR=3.401),and CA125≥334.11 U/mL(OR=4.679)were independent risk factors for poor prog-nosis in endometrial cancer(P<0.05).Conclusion The combination of transvaginal ultrasound parameters(PSV,PI,RI)and CA125 can effectively evaluate the pathological grading and prognosis of endometrial cancer,with superior diagnostic perfor-mance compared to individual indicators,demonstrating high clinical value.