Clinical staging and histopathological findings after radical hysterectomy in FIGO stage IIB cervical cancer.

PURPOSE: Advanced cervical cancer still represents a major health care challenge in the developing world. According to standard protocols the treatment of choice for stage IIB cervical cancer is cisplatin-based chemoradiotherapy. However, in some European countries, and especially in Japan, patients with stage IIB cervical cancer are generally treated with radical hysterectomy as initial treatment. The aim of this study was to compare clinical stage with pathological findings, and also to correlate any relationship between parametrial infiltration and nodal status. PATIENTS AND METHODS: From 1997 to 2006, 26 patients with FIGO stage IIB cervical cancer were radically operated (Piver class III operation). Preoperative clinical findings were compared with the pathological findings of the surgical material. The correlation between infiltration of the parametria and lymph node status was also examined. Fisher's exact test was used to examine statistical significance. RESULTS: The patients' median age was 48.3 years (range 36-61). The median number of removed lymph nodes was 16 (range 8-40). The histopathological types of cervical tumors were: squamous cell carcinoma 80%, adenosquamous carcinoma 15% and adenocarcinoma 5%. In 50% of the patients the parametria were infiltrated, suggesting that 50% of the patients were clinically overstaged. Positive lymph nodes were found in 69% of patients with positive parametria and 15% in patients with negative parametria (p <0.05). Patients with positive lymph nodes received adjuvant chemoradiotherapy. CONCLUSION: Adequate preoperative staging such as clinical examination under anesthesia or nuclear magnetic resonance could help to exclude parametrial involvement in equivocal cases. Parametrial invasion presents an important risk factor for lymph nodes metastases.

Clinical-sonographic scoring system in noninvasive diagnosis of endometrial cancer.

PURPOSE: In 90% of all endometrial cancers vaginal bleeding is the leading clinical symptom. Nowadays, scoring systems have become acceptable in medicine as less invasive, adequate, diagnostic methods. The main goal of this study was to examine the clinical-sonographic scoring system as a noninvasive diagnostic method for endometrial cancer. PATIENTS AND METHODS: The study included 122 patients with postmenopausal bleeding (PMB). Transvaginal sonography was performed before curettage. Patients were divided in two groups (A and B). In group A included were patients without endometrial malignancy and in group B were patients with endometrial cancer. A clinical-sonographic scoring system named ONCO 1 was created. Each patient got her own score based on anamnesis, clinical examination, and transvaginal ultrasonography. Evaluations of the clinical-sonographic scoring system were performed by using the test for diagnostic accuracy and receiver operating characteristic (ROC) curve. RESULTS: Patients with endometrial cancer were older (median age in group B 64.49 years vs. 58.81 in group A), the length of corpus uteri was longer (6.41 cm in group B vs. 5.25 cm in group A), and the postmenopausal period was longer (13.67 years median in group B vs. 9.11 in group A). All parameters were statistically significant. The average value of clinical-sonographic scoring system ONCO 1 in group A was 7.13, +/-3.07 SD and in group B it was 9.14, +/-2.32 SD. The difference was statistically significant. CONCLUSION: Postmenopausal bleeding caused by endometrial cancer is usually diagnosed in older patients. It was possible to distinguish high-risk patients with neoplasia from those with benign changes of the endometrium using the clinical-sonographic systems ONCO 1. Nevertheless, histopathological examination is still unavoidable for the final diagnosis of endometrial cancer.

[Use of the hybridization in situ method in the detection of human papillomaviruses in female genital tumor tissue]. / Izucavanje mogucnosti primene metode hibridizacije in situ u otkrivanju humanih papilloma virusa (HPV) u tumoroznom tkivu genitalijazena.

We review preliminary results obtained by use of this diagnostic procedure--hybridization in situ for diagnosis of human papilloma virus in bioptic material of anogenital tract in women. Of 11 examined bioptic specimens, we found positive hybridization signal on "test" groups HPV 6, 11 and HPV 16, 18. This is the first report on papilloma virus in women from the territory of Vojvodina.