Résumé
OBJECTIVE: To review recurrence and prognosis of microivasive squamous cell carcinoma of the cervix that are associated with depth of invasion, pathologic finding and management(conservative or radical treatment) STUDY DESIGN: We conducted retrospective study in order to evaluate the results of therapeutic approaches in 46 patients with microinvasive cervical cancer from Jan 1987 to Oct 1996. RESULT: The mean age of patients was 44.6+ 8.86 years. Only one woman was nullipara, and the mean parity was 2.8, Overall diagnostic accuracy of pap smear and punch biopsy were 54.3% and 79.4%. As the depth of invasion was deeper, the diagnostic accuracy of punch biopsy increased(p<0.05), The confluence pattern and lymphovascular space involvement were observed in 39.1% and 4.9%. The confluence pattern was observed with statistical significant in advanced depth of stromal invasion. In the surgical management, vaginal hysterectomy was done in 28 patients, conization(l patient), total abdominal hysterectomy(8 patients) and radical hysterectomy with pelvic lymph node dissection(9 patients) was done, no positive node was in 104 pelvic lymph node dissected. Though all cone margin was free and all endocervical curettage was negative, residual lesion(2 patients) was present in the hysterectomy after conization, The median follow-up period was 64 months. There was no recurrence in all cases and 5 years survival rate was 100% CONCLUSION: We suggest that microinvasive carcinoma of the cervix may be the disease of good prognosis and no recurrence, and less radical therapy for the patients with microinvasive carcinoma may be sufficient.
Sujets)
Femelle , Humains , Biopsie , Carcinome épidermoïde , Col de l'utérus , Conisation , Curetage , Diagnostic , Études de suivi , Hystérectomie , Hystérectomie vaginale , Noeuds lymphatiques , Parité , Pronostic , Récidive , Études rétrospectives , Taux de survie , Tumeurs du col de l'utérusRésumé
The paraneoplastic nephrotic syndrome can be diagnosed by clinical and immunologic features. We have had a case of paraneoplastic nephrotic syndrome in the patients with aadeno-carcinoma of the lung, whose diagnosis was made by excluding other causes of nephrotic syndrome. The type of renal lesion was membranous glomerulopathy which commonly occurs in carcinoma. The quantity of proteinuria in this patient had decreased according to the improvement of lung cancer with combination chemotherapy. After fourth chemotherapy he was refractory to treatment, and unfortunately he had passed away with cardiac tamponade.