Vidal Urbinati Ailyn M, Pino Ida, Iacobone Anna D, Radice Davide, Azzalini Giulia, Guerrieri Maria E, Preti Eleonora P, Martella Silvia, Franchi Dorella
Preventive Gynecology Unit, European Institute of Oncology IRCCS, 20141 Milan, Italy.
Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy.
Diagnostics (Basel). 2022 Nov 22;12(12):2904. doi: 10.3390/diagnostics12122904.
This study aims to analyze the sensitivity of vaginosonography (VGS) and magnetic resonance imaging (MRI) in the preoperative local evaluation of early-stage cervical cancers and to assess their accuracy in the detection of tumors, size of the lesions and stromal invasion by comparing them with the final histopathology report. This single-center study included 56 consecutive patients with cervical cancer who underwent VGS and MRI from November 2012 to January 2021. VGS significantly overestimated the lesion size by 2.7 mm (p = 0.002), and MRI underestimated it by 1.9 mm (p = 0.11). Both MRI and VGS had a good concordance with the pathology report (Cohen’s kappa of 0.73 and 0.81, respectively). However, MRI had a false-negative rate (38.1%) that was greater than VGS (0%) in cases of cervical tumor size <2 cm. We found a good concordance between histology and VGS in the stromal infiltration assessment, with 89% sensitivity (95% CI 0.44−0.83) and 89% specificity (95% CI 0.52−0.86). VGS is a simple, inexpensive, widely available, and fast execution method that can complement ultrasound in particular cases and show a good correlation with MRI in the assessment of tumor dimensions, with a better performance in detecting small tumors (<2 cm).
本研究旨在分析阴道超声检查（VGS）和磁共振成像（MRI）在早期宫颈癌术前局部评估中的敏感性，并通过与最终组织病理学报告进行比较，评估它们在肿瘤检测、病变大小及间质浸润检测方面的准确性。这项单中心研究纳入了2012年11月至2021年1月期间连续56例接受VGS和MRI检查的宫颈癌患者。VGS显著高估病变大小2.7毫米（p = 0.002），而MRI低估病变大小1.9毫米（p = 0.11）。MRI和VGS与病理报告均具有良好的一致性（Cohen's kappa系数分别为0.73和0.81）。然而，在宫颈肿瘤大小<2厘米的病例中，MRI的假阴性率（38.1%）高于VGS（0%）。我们发现组织学与VGS在间质浸润评估方面具有良好的一致性，敏感性为89%（95% CI 0.44−0.83），特异性为89%（95% CI 0.52−0.86）。VGS是一种简单、廉价、广泛可用且执行快速的方法，在特定情况下可补充超声检查，并且在肿瘤大小评估方面与MRI具有良好的相关性，在检测小肿瘤（<2厘米）方面表现更佳。
