Köse Gültekin, Aka Nurettin, Api Murat
Department of Obstetrics and Gynecology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
Gynecol Obstet Invest. 2003;56(2):70-6. doi: 10.1159/000072780. Epub 2003 Aug 5.
The aim of the study was to assess the depth of myometrial invasion and cervical involvement by endometrial cancer using preoperative 6.5-MHz, high-frequency transvaginal ultrasonography as compared with postoperative assessment using histopathological examination. The study included 47 patients with histologically proven cancers of the endometrium. All patients underwent transvaginal sonography before surgery. The depth of myometrial invasion was classified as none, inner half of the uterine wall, and outer half of the uterine wall. Cervical spread is recorded as positive or negative. Of 36 (76.6%) patients with proven myometrial invasion, 33 cases (91.66%) were revealed by sonography. Histologically proven cervical invasion that correlated with sonography was shown in 3 patients (75%). In 7 patients (14.9%) ultrasonography could not correctly predict the depth of myometrial invasion. The depth of invasion was underestimated in 4 (8.5%) cases and overestimated in 3 (6.4%) cases. Preoperative assessment of invasion of the uterine wall and cervical spread by transvaginal ultrasonography had an accuracy of 85 and 97.8% if correlated with the definitive histopathological examination. The role of transvaginal ultrasonography in preoperative assessment of the depth of myometrial invasion and cervical involvement in patients with endometrial cancer needs to be studied further before making reliable conclusions.
本研究的目的是，通过术前6.5兆赫高频经阴道超声检查评估子宫内膜癌的肌层浸润深度和宫颈受累情况，并与术后组织病理学检查评估结果进行比较。该研究纳入了47例经组织学证实患有子宫内膜癌的患者。所有患者在手术前均接受了经阴道超声检查。肌层浸润深度分为无、子宫壁内半层和子宫壁外半层。宫颈扩散记录为阳性或阴性。在36例（76.6%）经证实有肌层浸润的患者中，超声检查发现了33例（91.66%）。3例（75%）经组织学证实的宫颈浸润与超声检查结果相关。7例（14.9%）患者的超声检查未能正确预测肌层浸润深度。4例（8.5%）病例浸润深度被低估，3例（6.4%）病例被高估。如果与最终的组织病理学检查结果相关，经阴道超声检查对子宫壁浸润和宫颈扩散的术前评估准确率分别为85%和97.8%。在得出可靠结论之前，经阴道超声检查在子宫内膜癌患者肌层浸润深度和宫颈受累术前评估中的作用需要进一步研究。
