الفهرس 
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Abstract
Endometrial carcinoma is one of the most common gynecologic malignancies. The incidence rate of endometrial carcinoma is increasing surprisingly in both developing and developed countries.
Endometrial cancer patients often present with symptoms and signs that result in the diagnosis of their disease in the early stages and therefore most of them have an excellent prognosis. So, the utility of a tumor marker as a screening tool in the general population is not as critical as a marker for early detection in cancers that are most often diagnosed in the late stages such as ovarian cancer. However, for women that are at increased risk for the development of endometrial cancer such as women with Lynch11 syndrome and breast cancer patients on Tamoxifen there may be value in a tumor marker to aid in screening for endometrial cancer.
Alternatively, for women already diagnosed with endometrial cancer who are at high risk for recurrence of their disease or for patients with systemic and advanced stage disease, sensitive tumor markers for monitoring are needed.
The purpose of study was to evaluate the relation between serum level of visfatin and endometrial carcinoma.
This study was applied on 88 females attending EL Shatby Maternity Hospital, Alexandria University, all were divided into two groups.
group A: 44 cases diagnosed as endometrial carcinoma as evidenced by histopathological reports.
group B: 44 healthy control subjects.
There were no statistically significant differences between the two studied groups regarding age and BMI, however there were difference according to gravidity and parity.
Pre-operative blood samples were collected from the patients and controls then centrifuged, the serum withdrawn and frozen at -80 C within four hours of collection. The serum samples were analyzed to detect the level of visfatin in every patient.
Comprehensive surgical staging using peritoneal wash, total abdominal hysterectomy, bilateral salpingoopherectomy and pelvic lymphadenectomy was done to detect the histopathological type, stage, grade of endometrial cancer and if there is lymphatic metastases.
In the present study, visfatin level was statistically significantly higher in patients with endometrial carcinoma when compared with control (p=0.000). from the Receiver Operating characteristic (ROC) Curve analysis, we found that visfatin is a good indicator for diagnosis and anticipation of endometrial cancer. The best cut off that maximizes (sensitivity + specificity) is 18.9 (ng/ml). At this level, the sensitivity is 93.18% and specificity is 95.45%.
We correlate the level of visfatin with the stage and myometrial invasion there was significant correlation between the level of visfatin and all previous items while no statistically significant relation with the grade of the tumour.
The level of visfatin was elevated in patients with stage I more than other stages, this finding suggests that visfatin is a sensitive marker and it will be more effective for early diagnosis of endometrial cancer, detecting early recurrence and for monitoring response to treatment.
Serum visfatin level was elevated in patients with type I EC more than patients with type II EC.