Evaluation of depth of myometrial invasion by gross visual estimation versus microscopic technique.

A diagnostic test evaluation was performed to compare the evaluation of depth of myometrial invasion by gross visual estimation versus microscopic examination in the uteri of 40 patients who had endometrial adenocarcinoma and underwent surgical treatment in Siriraj Hospital from November 1993 to March 1995. The accuracy of gross visual estimation was 85%, the sensitivity was 63.6% (95% CI=31.6-87.6), the specificity was 93.1% (95%CI=75.8-98.8), the positive predictive value was 77.8% (95% CI=40.2-96.1), the negative predictive value was 87.1% (95% CI=69.2-95.8), the false positive rate was 6.9% and the false negative rate was 36.4%. Although gross visual estimation showed good specificity, high false negative rate and should not be used in preference to microscopic examination.

Primary ovarian cancer: A five-year review.

This retrospective study reports on 187 cases of ovarian carcinoma treated at Siriraj Hospital over five-year period from 1988-1992. The incidence was 17.6% of all ovarian tumors. Common epithelium was the most common group found in this study (85%). A total of 9.1% of the patients were in the germ cell group and the rest were in the stromal cell group (5.9%). The mean ages of the common epithelium germ cell and stromal cell groups were 47.5+14, 28.6+17.4 and 56.9+18.3 years respectively. The common presenting symptom was either abdominal mass (40.1%) or abdominal bloating (32.6%). The tumors, which developed in nearly three-fourths of the patients (72.2%), were between 6.20 cm in greatest diameter. Serous, dysgerminoma and granulosa cell tumors were the most common cell types found in the common epithelium, germ cell and stromal cell groups respectively. Half of the patients (50.8%) were in an advanced stage of the disease and radical surgery was performed in 62.3% of the patients.

Relationship between cervical cone margins and residual lesions in subsequent hysterectomy.

A cross-sectional study was performed to assess the relationship between cervical conization specimens (pathological diagnosis of CIN III or MIC) and subsequent hysterectomy specimens from 140 patients at Siriraj Hospital. It was found that the pathological diagnosis of CIN III and MIC were related significantly to the lesions found at cervical cane margins (29.8% and 57.7% respectively, P < 0.01) but no relationship to the residual lesions in subsequent hysterectomy (P > 0.05). 98.9% of cone specimens with margin-free have been found absent of residual lesions in subsequent hysterectomy whereas 61.2% of involved margins have been present. Lestions at cervical cone margins were related significantly (P <0.01) to residual lesions in subsequent hysterectomy and could be an appropriate guideline in further management for patients undergone cervical conization.