الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Introduction: Endometrial cancer is a cancer of developed world. In Europe and USA it is the most common gynecological cancer and the fourth most common female cancer after breast, lung, and colon cancer. Obesity, Nulliparity, late menopause, diabetes mellitus, hypertension, unopposed estrogen therapy, Tamoxifen therapy and atypical endometrial hyperplasia are the most common risk factors for endometrial carcinoma. Aim of work: To evaluate the effect of pelvic lymphadenectomy in the management of patients in clinical stage I endometrial carcinoma. Patients and methods: This study was carried out on 38 patients of histologically confirmed endometrial carcinoma, clinical stage I during the period from April 2005 to October 2008. These patients were subjected to D&C to confirm the diagnosis, detect P53 overexpression and Bcl-2 gene expression by immuno-histochemical staining. After completing laboratory assessment of the patients, they were subjected to surgical treatment and according to the method of surgical interference the patients were randomly classified into two groups. Group A were subjected to total abdominal hysterectomy and bilateral salpingo-oophrectomy, while group B subjected to total abdominal hysterectomy and bilateral salpingo-oophrectomy with systemic pelvic lymphadenectomy. Results: P53 gene mutation was found in 47.4% of cases of the studied group (18 of 38). P53 gene mutation was found to be associated with high grade of the disease, P value 0.037 ”Significant”. P53 gene mutation was associated with advanced surgical stage of the disease, P value 0.013 ” Significant”. Bcl-2 gene expression was found in 63.2% of patients of our studied group. Bcl-2 gene expression was found to be associated with well differentiated grade of the disease, P value 0.006 ” significant”. Bcl-2 gene expression was found to be associated with early FIGO surgical staging as it was high in stage I (70%), while in stage III it was (25%) P value was 0.018 ” significant”. So there was down regulation of bcl-2 gene expression with advanced stage endometrial cancer. Conclusions: Pelvic lymphadenectomy in early stage endometrial cancer increases the operative time and the need for blood transfusion, without an increase in complication rate, also pelvic lymphadenectomy in early stage endometrial cancer increases the survival time but it has no effect on the overall survival.