Department of Ultrasound, Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong Province, China
Pathological Diagnosis Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
Int J Gynecol Cancer. 2021 Dec;31(12):1535-1540. doi: 10.1136/ijgc-2021-002860. Epub 2021 Oct 28.
Although ultrasonography has been reported to have similar diagnostic accuracy to magnetic resonance imaging, it is not a standard imaging modality for cervical cancer. We aimed to summarize the ultrasonographic features of rare primary cervical cancer.
This was a retrospective study of patients with cervical cancer who were diagnosed between June 2014 and October 2019. They were divided into common-type cervical cancer (ie, cervical squamous cell carcinoma) and rare-type cervical cancer groups including adenocarcinoma, adenosquamous carcinoma, and small cell carcinoma. All patients were staged according to the tumor, nodes, and metastases criteria.
Of the 64 patients, the diagnosis was suspected on ultrasonography in 61 (95.3%) patients and missed on ultrasonography in three patients. The tumor size was smaller in the rare-type cervical cancer group (p<0.05). Hypoechoic lesions in common-type cervical cancer and isoechoic lesions accounted for 74.4% (32/43) and 61.9% (13/21) of patients in the rare-type cervical cancer group, respectively (p<0.001). Meanwhile, 67.4% (29/43) of tumors in common-type cervical cancer were exophytic, while 66.7% (14/21) in rare-type cervical cancer were endophytic (p=0.01). Color Doppler blood signals, as compared with normal cervical tissue, were found in all patients. There was good consistency between ultrasonographic and pathologic diagnosis of rare-type cervical cancer (weighted kappa=0.87).
Most patients with rare-type cervical cancer present with isoechoic lesions. The coincidence rate between ultrasonographic and pathologic diagnosis of rare-type cervical cancer is 87%.
尽管超声检查已被报道具有与磁共振成像相似的诊断准确性，但它并不是宫颈癌的标准影像学检查方式。我们旨在总结罕见的原发性宫颈癌的超声特征。
这是一项回顾性研究，纳入了 2014 年 6 月至 2019 年 10 月期间被诊断为宫颈癌的患者。他们被分为普通型宫颈癌（即宫颈鳞状细胞癌）和罕见型宫颈癌组，包括腺癌、腺鳞癌和小细胞癌。所有患者均根据肿瘤、淋巴结和转移标准进行分期。
在 64 例患者中，61 例（95.3%）患者的超声检查结果提示疑似宫颈癌，3 例漏诊。罕见型宫颈癌组的肿瘤直径较小（p<0.05）。普通型宫颈癌的低回声病变和罕见型宫颈癌的等回声病变分别占 74.4%（32/43）和 61.9%（13/21）（p<0.001）。同时，普通型宫颈癌的 67.4%（29/43）的肿瘤为外生性，而罕见型宫颈癌的 66.7%（14/21）为内生性（p=0.01）。彩色多普勒血流信号在所有患者中均与正常宫颈组织相比有增强。罕见型宫颈癌的超声与病理诊断具有良好的一致性（加权 kappa=0.87）。
大多数罕见型宫颈癌患者的超声表现为等回声病变。罕见型宫颈癌的超声与病理诊断的符合率为 87%。
