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A comparative study of pre‐operative procedures to assess cervical invasion by endometrial carcinoma
Author(s) -
Toki Toshihiko,
Oka Kenji,
Nakayama Kuniaki,
Oguchi Osamu,
Fujii Shingo
Publication year - 1998
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1998.tb10151.x
Subject(s) - hysteroscopy , curettage , magnetic resonance imaging , medicine , endocervical curettage , likelihood ratios in diagnostic testing , positive predicative value , radiology , carcinoma , cervix , cervical carcinoma , gynecology , predictive value , colposcopy , diagnostic accuracy , pathology , cervical cancer , cancer
Objective To compare the accuracy of different diagnostic procedures currently used to assess cervical involvement in endometrial carcinoma. Design Retrospective observational study. Setting Department of Obstetrics and Gynecology, Shinshu University Hospital, Matsumoto, Japan. Participants 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. Results 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 for assessing mucosal involvement to magnetic resonance imaging. Conclusion Endocervical curettage is a good test for excluding cervical involvement by endometrial carcinoma. Hysteroscopy is a good test in making both positive and negative diagnoses for cervical involvement. Magnetic resonance imaging is an excellent test for detecting cervical involvement, especially when the stroma is invaded.