Author/Authors :
akyol, alpaslan firat üniversitesi - tip fakültesi - kadin hastaliklari ve dogum anabilim dali, Elazig, turkey , yavuzkir, şeyda firat üniversitesi - tip fakültesi - kadin hastaliklari ve dogum anabilim dali, Elazig, turkey
Abstract :
Objective: To evaluate the pre-operative diagnostic efficacy of transvaginal ultrasonography (TVUS) in the evaluation of depth of myometrial infiltration, cervical and adnexal spread in patients with endometrial cancer. Materials and Methods: The data of 42 patients with endometrial cancer were evaluated retrospectively. TVUS was performed in all cases as part of routine pre-operative evaluation during the 7-day preoperative period. Total abdominal hysterectomy, bilateral salpingo-oophorectomy and routine surgical staging were performed in all patients. Myometrial invasion, cervical and adnexal involvement were evaluated by transvaginal ultrasonography. Patients were divided into two groups according to depth of myometrial invasion: 50% and ≥50% invasion. TVUS findings and final histopathological findings were compared. Results: The sensitivity, specificity, positive predictive value, negative predictive value of pre- operative ultrasonography in assessing depth of myometrial invasion 50% were 82%, 71%, 85%, 67%, and ≥ 50% myometrial invasion evaluation rates were 71%, 82%, 67% and 85% respectively. Sensitivity, specificity, positive predictive value and negative predictive value in evaluating cervical metastasis 60%, 89%, 42% and 94%, respectively. The efficacy in evaluating adnexal involvement was 67%, 86%, 44% and 93%, respectively. The sensitivity of TVUS in detecting 50% myometrial invasion was significantly higher than in detecting cervical spread (P=0.04). Conclusion: While TVUS is a reliable method for the evaluation of myometrial invasion in endometrial cancer, it has a lower sensitivity in the evaluation of cervical and adnexal metastases. As the image quality and resolution increase in ultrasonography, its diagnostic sensitivity will increase.
