Clinical Usefulness of Transvaginal sonography and sonohysterography in evaluation of endometrial abnormalities / 대한산부인과학회지

OBJECTIVE: The aim of our study is to evaluate the clinical usefulness of transvaginal sonography (TVS) and saline infusion sonohysterography (SHG) in the evaluation of endometrial abnormality. METHODS: We retrospectively reviewed 370 patients with abnormal uterine bleeding or uterine cavity abnormalities confirmed by TVS. SHG was carried out by experienced gynecologist, on the same setting in an outpatient clinic after the performance of TVS. Two hundred nineteen patients aged between 23 and 69 years (mean age 41+/-8.2) had operative hysteroscopy (88.2%), hysterectomy (9.1%) and dilatation/curettage (2.7%) within 3 months which provided a detailed description of uterine cavity. Surgical-pathologic findings were compared with the results obtained from TVS and SHG. RESULTS: The sensitivity and specificity were 71.7% and 31.4% for TVS, and 98.4% and 67.6% for SHG respectively. The positive and negative predictive values were 84.6% and 17.5% for TVS, and 94.3% and 92.3% for SHG, respectively. Twenty one cases showed a discrepancy between the TVS and SHG, and 16 cases showed a discrepancy between SHG and the pathologic diagnosis. Fifty five cases (25%) in TVS were unconfirmed, but SHG showed 51 pathologic confirmed intracavitary lesion. CONCLUSION: SHG is a sensitive tool and is superior to TVS used alone for evaluation of endometrial abnormalities. SHG definitely enhances the diagnostic potential of TVS in assessment of endometrium and intracavitary pathologies.

Comparison of prognosis of FIGO stage IB 1 adenocarcinoma and squamous cell carcinoma who were treated primarily by surgery / 부인종양

OBJECTIVE: The objective of this study was to compare clinical and pathologic variables and prognosis of FIGO stage IB 1 adenocarcinoma and squamous cell carcinoma of uterine cervix who were treated primarily by surgery. METHODS: From May 1982 to October 2000, 2,209 patients with invasive cancer of the uterine cervix were diagnosed and treated at Cheil Hospital. A retrospective review was performed of 533 patients with stage IB1 squamous cell carcinoma (group A) and 84 with adenocarcinoma (group B) of cervix who treated primarily by type 3 hysterectomy and pelvic and paraaortic lymphadenectomy. RESULTS: Age, endometrial extension, lymph node metastasis and postoperative adjuvant therapy were not different between two group. There were more the lymphovascular space invasion in group A (136 patients, 25.5%) than group B (9 patients, 10.7%) (p<0.0046). 5 year survival were 95.0% vs 93.8% for group A and group B (p=0.75). Using univariate analysis, pelvic node metastasis, paraaortic metastasis, postoperative adjuvant therapy were significant for survival. Multivariate analysis of 5 year survival revealed independent prognostic factor as postoperative adjuvant therapy. CONCLUSION: Prognosis of FIGO stage IB1 cervical cancer patients who were treated by primarily by type 3 hysterectomy and pelvic and paraaortic lymphadenectomy between adenocarcinoma and squamous cell carcinoma was found to be same.