To summarize the ultrasonic features of endometrial carcinoma in transvaginal color Doppler sonography (TVCDS), and to analyze the supplementary function of serum CA₁₂₅ and CA₁₉₉ in diagnosing endometrial carcinoma.

From January 2006 to October 2012, fourteen thousand and twenty-seven women underwent TVCDS in GZ Women & Children Medical Centre, serum CA₁₂₅ and CA₁₉₉ were determined by chemiluminescence immunoassay. The ultrasound characteristics of 131 cases of endometrial carcinoma (including 64 cases of early-stage and 67 cases of advanced endometrial carcinoma) who were accurately diagnosed by pathology and the value of serum CA₁₂₅ and CA₁₉₉ were analyzed.

In groups 131 patients were accurately confirmed by pathology, including 64 cases early-stage and 67 cases advanced carcinoma. The diagnositic coincidence of ultrasound and ultrasound combined with serum tumor markers was 56.3% (36/64) and 78.1% (50/64) respectively. On ultrasonography, 64 patients with early stage endometrial carcinoma showed uterine enlargement in 38 cases and endometrial thickening in 53 cases. In 9 cases, endometrial lesions were heterogeneously hypoechoic. In 55 cases, the halo between endometrium and muscle was interrupted and disappeared. In 56 cases, endometrial lesions had muscular layer infiltration. In 13 cases, endometrial lesions had cervical infiltration. In 61 cases, sparse punctuate or reticular flow signals were detected within lesions. In 3 cases, there was no blood flow signal in lesions. All these patients had not lymph node metastasis. Sixty-seven cases with advanced endometrial carcinoma showed more obviously uterine enlargement and significant endometrial thickening. In 61 patients, tumor spread outside the uterus. Reticular or dendritic flow signals were detected in 67 cases lesions. There were hypoechoic lymph node mestastasis in 53 cases. In 31 cases of early stage endometrial carcinoma, preoperative CA₁₂₅ increased. In 27 cases of early stage endometrial carcinoma, preoperative CA₁₉₉ increased. In 24 cases CA₁₂₅ and CA₁₉₉ increased meanwhile. In 61 cases of advanced endometrial carcinoma, preoperative CA₁₂₅ increased. In 59 cases of advanced endometrial carcinoma, preoperative CA₁₉₉ increased. In 56 cases CA₁₂₅ and CA₁₉₉ increased meanwhile. Sixty-four cases of early-stage endometrial carcinoma were diagnosed by TVCDS assisted with CA₁₂₅ and CA₁₉₉ and were confirmed by pathology. The detective rate was 78.1% (50/64). To compared with TVCDS, the difference was statistical significance (χ²=6.95, P=0.01).

The ultrasonic features of early-stage endometrial carcinoma in TVCDS were uterine enlargement, endometrial thickening, heterogeneous hypoechoic endometrial lesions, interrupted or disappeared hypoechoic halo between endometrium and musclar layer, and sparse punctuate or reticular flow signals within lesions. Serum CA₁₂₅ and CA₁₉₉ may be helpful in improving diagnosis coincidence rate when early-stage endometrial cancer is find or suspected on ultrasonography.