Abstract
Amaç: Endometriyum karsinomlar›nda miyometriyal invazyon
ve servikal tutulumun önceden belirlenmesi, “Operasyon esnas›nda
lenfadenektomi yap›lacak m›?” sorusunun yan›t›n›n ana belirleyicilerindendir.
Bu çal›flmada preoperatif ultrasonografik inceleme ile miyometriyal
invazyon ve servikal tutulumun de¤erlendirilmesi amaç-
lanm›flt›r.
Materyal ve Metot: Kad›n Hastal›klar› Kliniklerinde 2005 - 2007
y›llar› aras›nda çeflitli nedenlerle tedavi edilen 50 hasta çal›flmaya dahil
edilmifltir. Preoperatif full küretaj ile histopatolojik endometriyal
yap›s› tespit edilen bu hastalara, transvajinal ultrasonografi yap›larak
endometriyal bazal tabakadan miyometriyum içine uzanan endometriyum
dansitesindeki alanlar invazyon olarak de¤erlendirilip, hastalar
yüzeyel invazyon, 1/2’den fazla ve 1/2’den az invazyon olarak s›n›fland›r›lm›flt›r.
Servikal yay›l›m pozitif veya negatif olarak kay›t edilmifltir.
Bu bulgular operasyon s›ras›nda elde edilen spesimenlerden
k›yaslanarak ultrasonografinin bu amaçla preoperatif kullan›labilirli¤i
de¤erlendirilmifltir.
Bulgular: Servikal tutulumu olan 7 hastan›n 6’s›nda ultrasonografik
olarak bu durum tespit edilebilmifltir (sensitivite %85,7; spesifite
%100). Yüzeyel endometriyal yay›l›m› olan 9 hastan›n 6’s› do¤ru olarak
de¤erlendirilmifl, bir hasta 1/2’den az, 2 hasta 1/2’den fazla miyometriyal
invazyona sahip olarak de¤erlendirilmifltir (sensitivite %66,6;
spesifite %100; do¤ruluk %47,4). Miyometriyumu 1/2’den az invaze
olan 24 hastan›n 18’ine do¤ru tan› konulmufl, 6 hastan›n miyometriyal
tutulumu 1/2’den fazla olarak de¤erlendirilirken, hiçbir hasta için yü-
zeyel tutulum düflünülmemifltir (sensitivite %75; spesifite %28,5; do¤-
ruluk %77,4). 1/2’den fazla miyometriyal invazyona sahip 17 hastan›n
13’ü do¤ru olarak teflhis edilmifltir (sensitivite %76,5; spesifite %11,1;
do¤ruluk %65,4).
Abstract
Aim: To assess the depth of myometrial invasion and cervical involvement
in endometrial cancer using preoperative 6.5-MHz, highfrequency
transvaginal ultrasonography is a crucial point to the question
“Is it necessary to perform “lymphadenectomy” during endometrial
carcinoma cases”. We aimed to f›nd the role of transvaginal ultrasonography
in preoperative assessment of the depth of myometrial invasion
and cervical involvement in patients with endometrial cancer.
Material and Method: The study included 50 patients with histologically
proven cancers of the endometrium between years 2005-2007
who attended to gynecology clinic. All patients underwent transvaginal
sonography before surgery. The depth of myometrial invasion
was classified as none, inner half of the uterine wall < 1/2, and outer
half of the uterine wall >1/2. Cervical spread is recorded as positive or
negative. The findings of the ultrasound examination are correlated
with the pathological specimen and the preoperative applicability of
ultrasound is evaluated.
Results: Histologically proven cervical invasion that correlated
with sonography was shown in 6 patients out of 7 (sensitivity %85,7;
specificity %100). Of 9 patients with proven superficial myometrial invasion,
6 cases were revealed correctly by sonography whereas the
depth of invasion was wrong estimated in 3 cases (sensitivity %66,6;
specificity %100; accuracy %47,4). Out of 24 patients with proven
myometrial invasion < 1/2, 18cases were correctly revealed by sonography.
In 6 patients ultrasonography could not correctly predict the
depth of myometrial invasion. The depth of invasion was overestimated
in 6 cases (sensitivity %75; specificity %28,5; accuracy %77,4). Out of
17 patients with proven myometrial invasion > 1/2, 13cases were correctly
revealed by sonography The depth of invasion was underestimated
in 4 cases (sensitivity %76,5; specificity %11,1; accuracy %65,4).
Details
| Other ID | JA76DN74TV |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | July 1, 2010 |
| Submission Date | July 1, 2010 |
| Published in Issue | Year 2010 Volume: 13 Issue: 3 |