Department of Obstetrics and Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Ann Med. 2023;55(2):2273428. doi: 10.1080/07853890.2023.2273428. Epub 2023 Oct 26.
This retrospective cohort study aimed to determine the prevalence of precancerous or malignant lesions of the cervix and/or endometrium among patients who underwent vaginal hysterectomy.
Medical record of patients who had been diagnosed with pelvic organ prolapse (POP) and undergone vaginal hysterectomy from January 2009 to September 2018 in tertiary hospital was reviewed. The exclusion criteria included individuals who had previously received a diagnosis of gynecologic precancerous lesions or cancer, had abnormal preoperative findings, presented abnormal cervical cancer screening test results or abnormal results from preoperative endometrial biopsy, and had incomplete operative notes or pathological results.
The electronic medical records of 530 patients were reviewed and included in the analysis. Nine of the 530 patients (1.7%) had precancerous or malignant lesions of the cervix and/or endometrium. The prevalence of atypical endometrial hyperplasia and endometrial carcinoma were 0.19% and 0.57%, respectively. All of the patients with endometrial cancer subsequently underwent complete surgical staging. Precancerous cervical lesions were found in five patients (0.95%): CIN II 0.38% and CIN III 0.57%. No cases of cervical cancer were identified.
It is possible to detect a minor prevalence of precancerous and malignant lesions following post-operative procedures in POP. The assessment of the elderly through the use of risk-based evaluation merits attention for the purpose of early identification. This study offers valuable insights that can be utilized in preoperative counseling and enhancing the preoperative evaluation process.
本回顾性队列研究旨在确定行阴道子宫切除术患者中宫颈和/或子宫内膜癌前病变或恶性病变的发生率。
回顾 2009 年 1 月至 2018 年 9 月在三级医院因盆腔器官脱垂(POP)而接受阴道子宫切除术的患者的病历。排除标准包括:既往诊断为妇科癌前病变或癌症的患者;术前检查结果异常的患者;宫颈癌筛查试验结果异常或术前子宫内膜活检结果异常的患者;手术记录或病理结果不完整的患者。
共回顾了 530 例患者的电子病历,并将其纳入分析。530 例患者中有 9 例(1.7%)患有宫颈和/或子宫内膜癌前病变或恶性病变。非典型子宫内膜增生和子宫内膜癌的发生率分别为 0.19%和 0.57%。所有子宫内膜癌患者随后均行完整的手术分期。5 例患者发现癌前宫颈病变(0.95%):CIN II 占 0.38%,CIN III 占 0.57%。未发现宫颈癌。
在 POP 术后的后续程序中,可能会发现少量的癌前病变和恶性病变。对老年人进行基于风险的评估值得关注,以达到早期识别的目的。本研究为术前咨询和增强术前评估过程提供了有价值的见解。