RESUMO
Objective To evaluate the value of transvaginal color Doppler ultrasonography for pathologic grading of endometrial cancer. Methods A total of 68 patients with histopathologic diagnosis of endometrial cancer were recruited as study subjects, and all patients underwent transvaginal color Doppler ultrasonography. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of transvaginal color Doppler ultrasonography for identification of myometrial invasion by endometrial cancer were evaluated among endometrial cancer patients with postoperative histopathological examinations as a gold standard. Results The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of transvaginal color Doppler ultrasonography were 70.0%, 67.9%, 75.7%, 61.3% and 69.1% for the detection of myometrial invasion by endometrial cancer, respectively. The resistance index values of left and right uterine arteries were both significantly higher in endometrial cancer patients with myometrial invasion ≤ 50% than those with myometrial invasion > 50% (P < 0.01), and the resistance index values of left and right uterine arteries increased with the reduced tumor grade among endometrial cancer patients (P < 0.05). Conclusion Transvaginal color Doppler ultrasonography shows a high accuracy for identification of myometrial invasion among endometrial cancer patients, which may be used as a non-invasive tool for preoperative pathologic grading of endometrial cancer.
RESUMO
WHO has issued three editions of pathologic classification of bladder urothelial carcinoma in 1973,1999 and 2004.The 1973 version classification had been widely and the longest applied.However,WHO 2004 classification had been prevalent in past years.There were two issues in the applications of WHO 2004 classification.On one hand,there were some difficulties in quick grading in a given case.On the other hand,there were some misunderstandings in the conversion of different WHO classification.In this article,the changes of different pathologic classification of bladder urothelial carcinoma were reviewed and the outline of different pathologic classification was generalized.The criterion of all the systems was cell anaplasia.In WHO 1973 version classification,the definition of the various grades was vague.It was relatively precise in WHO 1999 classification.However,the grading of Ⅰ,Ⅱ and Ⅲ in WHO 1999 classification still remained confusions.The major changes in WHO 2004 classification was that this system divided urothelial carcinoma into low-and high-grade,which may solve the heterogenesis of grade Ⅱ in the other two classifications.