RESUMEN
Objective To explore the value of endocervical curettage (ECC) in the detection of high-grade cervical squamous intraepithelial lesion (HSIL). Methods We retrospectively analyzed the clinical features and colposcopical characteristics of 678 female patients with complete clinical data. Results Among 678 cases, 391 cases were confirmed by cervical biopsy only and 7 cases by ECC only (57.67% vs. 1.03%, P < 0.001). ECC checked out 287 HSIL patients (42.33%, including cervical biopsy positive and negative cases) and cervical biopsy checked out 671 HSIL cases (98.97%, including ECC positive and negative cases). There were 68 positive ECC cases in the conversion area of Type 1+Type 2 and 247 positive ECC cases in the conversion area of Type 3(33.33% vs. 52.11%, P < 0.001). The positive rates of ECC in patients≥45 years old and < 45 years old were 145 and 170, respectively (55.13% vs. 40.96%, P < 0.001). Conclusion The cervical biopsy plays a dominant role in the detection of HSIL, and ECC can only be used as a supplement to it. Female patients older than 45 years or with Type 3 transformation zone examined by colposcopy should be concerned with cervical lesions.
RESUMEN
Objective To investigate the risk factors for ovarian metastasis and the possibility of ovarian preservation in patients with endometrial carcinoma.Methods The clinicopathological features of endometrial carcinoma patients who were diagnosed and treated initially with a surgical staging procedure from Jan 1997 to Dec 2006 in our hospital were retrospectively reviewed.Results Of the 638 cases reviewed,36(5.6%,36/638)had ovarian metastasis.Univariate analysis revealed that histological type and grade,myometrial invasion,positive peritoneal fluid cytology,pelvic lymph node metastasis,invasion of parauterine,para-aortic node metastasis and invasion of uterine serosa were significantly associated with ovarian metastasis(P＜0.05);while age,lymph-vascular invasion and cervical invasion wen not significantly associated with ovarian metastasis(P＞0.05). Factors predictive of ovarian metastasis by multivariate analysis were ranked as follows according to risk intensity:pelvic lymph node metastasis,positive peritoneal cytology,and histological grade.Conclusion In young patients with grode 1 endometrioid carcinoma,with no pelvic lymph node metastasis,no para-aortic lymph node metastasis,no myometrial invasion and with negative peritoneal fluid cytology,ovarian preservation could be considered.