宫颈癌子宫切除术中所见的淋巴血管间隙浸润，宫颈活检和切除手术标本缺乏足够的预测价值。

Cervical biopsy and excision procedure specimens lack sufficient predictive value for lymph-vascular space invasion seen at hysterectomy for cervical cancer.

作者信息

Bidus Michael A, Caffrey Angela S, You Whitney B, Amezcua Charles A, Chernofsky Mildred R, Barner Ross, Seidman Jeffrey, Rose G Scott

机构信息

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Walter Reed Army Medical Center, Washington, DC 20307, USA.

出版信息

Am J Obstet Gynecol. 2008 Aug;199(2):151.e1-4. doi: 10.1016/j.ajog.2008.02.017.

DOI:10.1016/j.ajog.2008.02.017

PMID:18674657

Abstract

OBJECTIVE

The purpose of this study was to determine whether lymph-vascular space invasion (LVSI) that is discovered in cervical biopsy and excision specimens is associated with LVSI in the hysterectomy specimen of patients with cervical cancer.

STUDY DESIGN

A retrospective pathologic review to determine the presence of LVSI in cervical biopsy specimens, cold-knife cone biopsy (CKC biopsy), and loop electrical excision procedure (LEEP) specimens that contained cervical cancer was performed if subsequent hysterectomy results were available for review. Data were analyzed with chi-square analysis testing.

RESULTS

One hundred six patients were identified. The negative predictive value of the biopsy is lower at 0.45 than either the CKC biopsy (0.83) or LEEP (0.57); however, the positive predictive value (0.83) is higher than either CKC biopsy (0.50) or LEEP (0.75). LVSI, when present in cervical biopsy (odds ratio, 4.13; 95% CI, 0.414-98.446), CKC biopsy (odds ratio, 4.8; 95% CI, 0.542-46.280), and LEEP (odds ratio, 4.0; 95% CI, 0.439-43.793) specimens, is associated with a statistically insignificant increased risk of LVSI in the hysterectomy specimen.

CONCLUSION

Cervical biopsy and excision specimens lack sufficient negative predictive value for the detection of LVSI in the hysterectomy specimen.

摘要

目的

本研究旨在确定在宫颈癌患者的宫颈活检和切除标本中发现的淋巴管间隙浸润（LVSI）是否与子宫切除标本中的LVSI相关。

研究设计

如果有后续子宫切除结果可供审查，则进行回顾性病理检查，以确定含有宫颈癌的宫颈活检标本、冷刀锥切活检（CKC活检）和环形电切术（LEEP）标本中LVSI的存在情况。采用卡方分析检验对数据进行分析。

结果

共纳入106例患者。活检的阴性预测值较低，为0.45，低于CKC活检（0.83）或LEEP（0.57）；然而，其阳性预测值（0.83）高于CKC活检（0.50）或LEEP（0.75）。当宫颈活检标本（优势比，4.13；95%可信区间，0.414 - 98.446）、CKC活检标本（优势比，4.8；95%可信区间，0.542 - 46.280）和LEEP标本（优势比，4.0；95%可信区间，0.439 - 43.793）中存在LVSI时，与子宫切除标本中LVSI风险增加相关，但差异无统计学意义。