Subbarayan Sanjeev Kishore, R Deepu, Dhanasingh Prabu
Radiodiagnosis, Department of Radiology, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Maduranthakam, IND.
Cureus. 2024 Oct 18;16(10):e71820. doi: 10.7759/cureus.71820. eCollection 2024 Oct.
Background and objectives Adenocarcinoma is increasingly being described in the histological profile of cervical cancer, which is a significant alteration in the disease's profile. This study, which highlights the rising incidence of adenocarcinoma in India, attempts to evaluate the relationship between magnetic resonance imaging (MRI) and histological findings in cervical cancer. The goal is to assess the utility of MRI in tumor staging and its consequences for the management of this evolving histological trend. Methods Forty-five patients with cervical cancer were included in a retrospective analysis; they had MRI scans and then histological examinations. We compared the MRI results for tumor size, lymph node involvement, and local invasion with histology, the gold standard for diagnosis. Correlation was evaluated using statistical analysis, which included chi-square tests; a p-value of less than 0.05 was considered significant. Results Magnetic resonance imaging showed good agreement with histology (p = 0.03) and was accurate in detecting lesions restricted to the cervix and parametrial infiltration. On the other hand, there were differences in the diagnosis of pelvic lymphadenopathy, which MRI underreported. Magnetic resonance imaging sensitivity was high for detecting parametrial invasion (88.24%) and for tumor extent (81.82%), but lower for lymph node involvement (56.25%). Compared to 47.06% of squamous cell carcinoma (SCC) cases, the study found a considerable increase in the number of instances of adenocarcinoma, with 54.55% of cases presenting in advanced stages. This pattern became statistically significant (p < 0.05), emphasizing the tendency of adenocarcinomas to manifest in their later stages. Conclusions When it comes to evaluating local tumor invasion, MRI is a dependable method for staging cervical cancer. However, other diagnostic techniques are required due to their limits in detecting lymphadenopathy. The need for better screening methods specific to this subtype is highlighted by the rising incidence of adenocarcinoma and its propensity for late-stage diagnosis. This will enable early detection and intervention.
背景与目的 腺癌在宫颈癌组织学特征中的描述日益增多,这是该疾病特征的一项重大改变。本研究突出了印度腺癌发病率的上升情况,试图评估磁共振成像(MRI)与宫颈癌组织学检查结果之间的关系。目的是评估MRI在肿瘤分期中的效用及其对这种不断演变的组织学趋势管理的影响。方法 对45例宫颈癌患者进行回顾性分析;这些患者先进行了MRI扫描,然后进行了组织学检查。我们将肿瘤大小、淋巴结受累情况和局部侵犯的MRI结果与组织学结果(诊断的金标准)进行了比较。使用包括卡方检验在内的统计分析评估相关性;p值小于0.05被认为具有统计学意义。结果 磁共振成像与组织学结果显示出良好的一致性(p = 0.03),并且在检测局限于宫颈的病变和宫旁浸润方面准确。另一方面,在盆腔淋巴结病的诊断上存在差异,MRI报告不足。磁共振成像检测宫旁侵犯(88.24%)和肿瘤范围(81.82%)的敏感性较高,但检测淋巴结受累的敏感性较低(56.25%)。与47.06%的鳞状细胞癌(SCC)病例相比,该研究发现腺癌病例数量有相当大的增加,54.55%的病例处于晚期。这种模式具有统计学意义(p < 0.05),强调了腺癌在后期表现的倾向。结论 在评估局部肿瘤侵犯方面,MRI是宫颈癌分期的可靠方法。然而,由于其在检测淋巴结病方面的局限性,还需要其他诊断技术。腺癌发病率的上升及其晚期诊断倾向凸显了针对该亚型更好筛查方法的必要性。这将有助于早期发现和干预。