Tarigan Vera Nevyta, Rahmawati Dewi Lestari, Octavius Gilbert Sterling
Breast and Female Reproductive Radiology, Department of Radiology, Faculty of Universitas Pelita Harapan, Tangerang, Indonesia.
Department of Radiology, Siloam Hospital Kebon Jeruk, Jl. Perjuangan No.8, RT.14/RW.10, Kb. Jeruk, Kec. Kb. Jeruk, Kota Jakarta Barat, Daerah Khusus Ibukota Jakarta, 11530 Indonesia.
J Obstet Gynaecol India. 2024 Aug;74(4):303-310. doi: 10.1007/s13224-024-02047-8. Epub 2024 Aug 23.
The use of transrectal ultrasound (TRUS) is established in prostate cancer but remains limited in cervical cancer. This systematic review aims to aggregate and describe the current use and advancements of TRUS in cervical cancer to identify gaps in the literature.
This study follows a protocol registered in the PROSPERO database (CRD42024520099). It includes cervical cancer patients confirmed by histopathological analysis, where TRUS was used for diagnosis or as an adjunct to therapeutic procedures. Cross-sectional, case-control, cohort, or randomized controlled trials published in any language were included. The risk of bias was assessed using the Newcastle Ottawa Scale (NOS).
From an initial pool of 3380 articles, 50 duplicates were removed, leaving 3330 unique articles. After screening titles and abstracts, 2932 articles were excluded, resulting in 31 studies included in the review. These studies involved 1635 women with cervical cancers, with a mean age of 52.9 years. Histopathologically, 81.2% were squamous cell carcinoma (SCC), and 39.6% were at FIGO stage IIB. Nineteen studies were prospective, five retrospective, and fourteen used consecutive sampling. Only 10 articles had a fair rating, while the rest received poor ratings. Complications from post-TRUS included pain ( = 106), haemorrhage ( = 59), and perforations ( = 10). TRUS was used in seven areas, including cancer extension and pre-operative assessment. It showed a strong correlation with MRI but had lower sensitivity. TRUS was useful in staging, diagnosis, and guiding brachytherapy, demonstrating comparable accuracy to MRI in several instances.
The recommended use of TRUS in cervical cancer is still limited in formal guidelines, and clinical research remains insufficient.
The online version contains supplementary material available at 10.1007/s13224-024-02047-8.
经直肠超声（TRUS）在前列腺癌中的应用已得到确立，但在宫颈癌中的应用仍然有限。本系统评价旨在汇总并描述TRUS在宫颈癌中的当前应用情况和进展，以找出文献中的空白。
本研究遵循在PROSPERO数据库（CRD42024520099）中注册的方案。纳入经组织病理学分析确诊的宫颈癌患者，其中TRUS用于诊断或作为治疗程序的辅助手段。纳入以任何语言发表的横断面、病例对照、队列或随机对照试验。使用纽卡斯尔渥太华量表（NOS）评估偏倚风险。
从最初的3380篇文章中，去除了50篇重复文章，剩下3330篇独特文章。在筛选标题和摘要后，排除了2932篇文章，最终有31项研究纳入本评价。这些研究涉及1635名宫颈癌女性，平均年龄为52.9岁。组织病理学上，81.2%为鳞状细胞癌（SCC），39.6%为国际妇产科联盟（FIGO）IIB期。19项研究为前瞻性研究，5项为回顾性研究，14项采用连续抽样。只有10篇文章评级为中等，其余文章评级较差。TRUS术后并发症包括疼痛（n = 106）、出血（n = 59）和穿孔（n = 10）。TRUS用于七个领域，包括癌症浸润范围评估和术前评估。它与磁共振成像（MRI）显示出很强的相关性，但敏感性较低。TRUS在分期、诊断和指导近距离放疗方面很有用，在某些情况下显示出与MRI相当的准确性。
在正式指南中，TRUS在宫颈癌中的推荐应用仍然有限，临床研究仍然不足。
在线版本包含可在10.1007/s13224-024-02047-8获取的补充材料。
