Clinical value of transvaginal, sonographically guided fine needle aspiration biopsy of parametria in recurrent cervical carcinoma.

Forty four patients with a clinically suspected relapse of cervical carcinoma were evaluated with transvaginal sonographically guided fine-needle aspiration biopsy (FNAB) of parametria in the Gynaecological Department of the Institute of Oncology, Warsaw, Poland. Sonographical scans and FNAB results were compared with subsequent clinical course (41 cases) and surgery (3 cases). Of the total of 56 aspiration biopsies 50 specimens were of cytological value. Overall diagnostic accuracy of FNAB was 82%, specificity and positive predictive value 100%, sensitivity 61% and negative predictive value 75%. As regards sonography the accuracy rate was 77%, the sensitivity as well as negative predictive value were 100%, specificity was 62% with false positive rate 23%. The definitive diagnosis of recurrence was obtained by FNAB in 13 out of 18 cases and in 8 of these radiotherapy was instituted. The negative FNAB correctly rules out the recurrent disease in 22 of 26 cases. In all cases with relapse parametrial lesions were detected on ultrasound scans. The Authors have found that sonographically guided FNAB of parametria is a useful diagnostic tool in imaging and biopsying of parametrial masses. As the conjunction of two complementary diagnostic methods this technique is an excellent tool for obtaining the cytologic verification of recurrence, especially in doubtful cases, when post-therapeutic pelvic fibrosis is present. It is also a quick, safe technique, well accepted by the patient.