[Value of fine needle aspiration biopsy in cervical cancer]

Correct staging qualification, especially evaluation of parametrium is very useful in choosing of adequate method of treatment, and thereby in patients' survival.

The aim of study was estimation of the value of fine needle aspiration biopsy in transvaginal ultrasonography assistant in preoperative assessment of parametria in cervical cancer. We compared parametrial infiltration before treatment and to verified and confirmed staging in cervical cancer postoperatively by histopathology.

64 women with cervical cancer in stage Ib, were included in the study. Assessment of parametrial invasion before treatment was performed by fine needle aspiration biopsy in endovaginal ultrasound assistants. The sonographic evaluation of parametria was performed by Siemens Sonoline Versa Pro with transvaginal 7 MHz mechanical transducer with the biopsy guide 14 cm long. All of patients with cervical cancer in stage Ib were operated on Wertheim-Meigs hysterectomy. The preoperative findings were compared with data obtained by histopathology findings. There were evaluated sensitivity, specificity and diagnostic accuracy of this method.

Accuracy of fine needle aspiration biopsy of parametrial involvement was 89%, sensitivity-70%, specificity-92.6%, PPV-63.6%, NPV-94.3%.

Transvaginal ultrasonography is superior to routine clinical examination in the assessment of parametria. Sensitivity of fine needle biopsy with ultrasound assistance is higher then of gynecological examination and ultrasound alone. Correct preoperative diagnosis may improve staging, treatment and indirectly, survival patients with cervical cancer.