Griffin T W, Parker R G, Taylor W J
AJR Am J Roentgenol. 1976 Nov;127(5):825-7. doi: 10.2214/ajr.127.5.825.
A review of 227 cases of invasive carcinoma of the cervix was undertaken to determine the efficacy of procedures using in the staging of this disease. All patients had a pretreatment chest radiography and intravenous pyelogram. 96.5% had pretreatment cystoscopy, 98.6% had pretreatment proctoscopy, and 92% had a pretreatment barium enema. These patients were retrospectively staged on the findings of physical examination only. Each additional procedure was then evaluated by comparison with the initial staging. Cystoscopy and chest film findings each would have changed the clinical stage in fewer than 1% of cases, barium enema in 1.4%, and proctoscopy in 2.2%. No patient had a positive barium enema without a positive proctoscopy, while two patients had positive proctoscopies with negative barium enemas. The overall yield of positive findings by pretreatment intravenous pyelography was 7.3%. Lymphangiography, although inconsistently done, yielded positive findings in all stages. Chest radiographs, intravenous pyelography, proctoscopy, and lymphangiography are recommended as part of the pretreatment workup of patients with carcinoma of the cervix. Routine barium enema is no longer recommended, and cystoscopy is only recommended in patients with clinical stage IIB disease or greater.
对227例宫颈浸润癌患者进行了回顾性研究，以确定用于该疾病分期的各项检查的效果。所有患者在治疗前均进行了胸部X线检查和静脉肾盂造影。96.5%的患者进行了治疗前膀胱镜检查，98.6%的患者进行了治疗前直肠镜检查，92%的患者进行了治疗前钡剂灌肠检查。这些患者仅根据体格检查结果进行回顾性分期。然后，将每项额外检查的结果与初始分期进行比较评估。膀胱镜检查和胸部X线检查结果改变临床分期的病例均不到1%，钡剂灌肠检查为1.4%，直肠镜检查为2.2%。没有患者钡剂灌肠检查阳性而直肠镜检查阴性，而有2例患者直肠镜检查阳性但钡剂灌肠检查阴性。治疗前静脉肾盂造影阳性结果的总体检出率为7.3%。淋巴管造影虽操作不规范，但各期均有阳性发现。推荐将胸部X线检查、静脉肾盂造影、直肠镜检查和淋巴管造影作为宫颈癌患者治疗前检查的一部分。不再推荐常规钡剂灌肠检查，仅推荐对临床分期为IIB期及以上的患者进行膀胱镜检查。
