A comparative study of pre-operative procedures to assess cervical invasion by endometrial carcinoma

British Journal of Obstetrics and Gynaecology
T TokiS Fujii

Abstract

To compare the accuracy of different diagnostic procedures currently used to assess cervical involvement in endometrial carcinoma. Retrospective observational study. Department of Obstetrics and Gynecology, Shinshu University Hospital, Matsumoto, Japan. Sixty-four patients with endometrial carcinoma were evaluated pre-operatively for cervical involvement by six different diagnostic procedures: cervical cytology, endocervical curettage, transvaginal ultrasonography, hysteroscopy, magnetic resonance imaging, and serum levels of CA125. The number of positive and negative diagnoses of cervical invasion by each of these procedures were correlated with the actual invasion determined by histological examination. Cervical invasion was confirmed in 12 (18.8%). Endocervical curettage showed high sensitivity (91%), the highest negative predictive value (96%), and the lowest negative likelihood ratio (0.14). Hysteroscopy showed high positive likelihood ratio (8.2) and low negative likelihood ratio (0.20). Magnetic resonance imaging showed the highest positive predictive value (75%) and the highest positive likelihood ratio (12.5). Magnetic resonance imaging was excellent for predicting stromal invasion, whereas hysteroscopy was superior fo...Continue Reading

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