Department of Obstetrics and Gynecology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Ultrasound Obstet Gynecol. 2011 Dec;38(6):707-15. doi: 10.1002/uog.9037. Epub 2011 Oct 11.
To determine the agreement between ultrasound and histological examination of the cervix in patients with early stage cervical cancer with regard to tumor size and local extent of the disease.
Eighteen patients with histologically proven cervical cancer Stage IB1-IIA according to traditional clinical staging (FIGO 1988) who were scheduled for radical surgery underwent a standardized transvaginal ultrasound examination. The maximum tumor length, anteroposterior tumor diameter, tumor width, tumor area, depth of cervical stroma invasion, and the minimal thickness of tumor-free cervical stroma on sagittal and transverse planes through the cervix were measured, and the local extent of the disease within the parametria and vagina were evaluated. The surgical specimens were examined using a specifically devised method of histopathological examination. The results of the ultrasound and histopathological examinations were compared.
Limits of agreement were wide and the intraclass correlation coefficient (ICC) was low (0.51-0.58) for three of the four measurements taken to represent the minimal depth of tumor-free cervical stroma, i.e. the results of the measurements taken posteriorly and laterally. However, the limits of agreement were narrower and the ICC values were higher (0.74-0.92) for the depth of cervical stroma invasion and for the tumor size measurements. Histological examination revealed parametrial cancer infiltration in four patients, which was detected during ultrasound examination, with no false-positive results.
Transvaginal sonography is acceptably accurate for evaluation of tumor size and depth of cervical stroma invasion in clinical practice.
确定超声与组织学检查在早期宫颈癌患者肿瘤大小和疾病局部范围方面的一致性。
18 例经组织学证实的宫颈癌患者，根据传统临床分期（FIGO 1988）为 IB1-IIA 期，拟行根治性手术，均接受标准化经阴道超声检查。测量最大肿瘤长度、前后径肿瘤直径、肿瘤宽度、肿瘤面积、宫颈间质浸润深度以及矢状面和通过宫颈的横断面肿瘤无蒂宫颈间质的最小厚度，并评估宫旁和阴道内疾病的局部范围。使用专门设计的组织病理学检查方法检查手术标本。比较超声和组织病理学检查结果。
有 4 个测量值中的 3 个（代表无蒂宫颈间质最小深度的测量值）的一致性界限较宽，组内相关系数（ICC）较低（0.51-0.58），即后部和侧面的测量值。然而，宫颈间质浸润深度和肿瘤大小测量值的一致性界限较窄，ICC 值较高（0.74-0.92）。组织学检查发现 4 例患者有宫旁癌浸润，超声检查时均有检出，无假阳性结果。
经阴道超声在评估肿瘤大小和宫颈间质浸润深度方面具有可接受的准确性，可用于临床实践。
