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The value of pre-operative diagnostic procedures for cervical involvement in uterine corpus carcinoma
Y Morimura1, S Soeda, T Hashimoto
1Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima City, Japan.
Objective:
To assess the value of procedures for pre-operative diagnosis of cervical involvement of uterine corpus carcinoma.
Materials And Methods:
Four diagnostic procedures, including cervical cytology, endocervical curettage (ECC), magnetic resonance imaging (MRI), and hysteroscopy, were performed for diagnosis of cervical involvement in 60 patients with uterine corpus carcinoma. The preoperative diagnosis based on results obtained using by each procedure was retrospectively compared with the diagnosis based on histological examination of surgical specimens. Data were analyzed according to the standard definition of sensitivity, specificity, positive predictive value and negative predictive value.
Results:
Cervical involvement was confirmed in 18 patients (30%). ECC showed high sensitivity (90.9%) and specificity (88.9%). Cervical cytology showed high specificity (88.6%). MRI showed very high specificity (99.2%) and high sensitivity (88.5%) in cases with cervical stromal invasion.
Conclusion:
Cervical cytology and MRI are useful for excluding cervical involvement. ECC is useful for positive diagnosis. MRI may be useful for cases with stromal invasion. The use of a combination of several procedures is essential for obtaining an accurate diagnosis of cervical involvement in cases of uterine corpus carcinoma.