Endometriyum kanseri tanısı alan hastalarda myometriyal invazyon derinliğinin incelenmesinde transvajinal ultrasonografi, magnetik rezonans görüntüleme yöntemi ve frozen patoloji incelenmesinin karşılaştırılması
Küçük Resim Yok
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada myometriyal invazyonu değerlendirmek amacıyla preop uyguladığımız transvajinal ultrasonografi (TVS), manyetik rezonans görüntüleme (MRG) yontemi ve operasyon esnasında patologlar tarafından yapılan frozen incelemenin nihai patoloji sonucu ile karşılaştırarak, yöntemlerin miyometriyal invazyon derinliğini saptamadaki etkinlik düzeylerini incelemeyi amaçladık. Gereç ve yöntem: Bu prospektif çalışmada, Şubat 2017 ile Ağustos 2018 tarihleri arasında İnonü Üniversitesi Turgut Özal Tıp Merkezi Kadın Hastalıkları ve Doğum kliniğinde diagnostik probe küretaj ile endometriyum kanseri tanısı alan 65 hastada myometriyal invazyon derinliği için ameliyat öncesi TVS, MRG ve operasyon esnasında ise frozen inceleme yapıldı. Her üç yöntemde de tek bir jinekolog, radyolog ve patolog tarafından değerlendirildi. Sonuçlar altın standart olarak nihai patoloji ile karşılaştırıldı. Veriler SPSS 22.0 istatistik paket programı kullanılarak analiz edilmiştir. Sonuçlar: Yaptığımız çalışmaya 65 hasta alındı. Hastaların yaşları 38 ile 89 arasında olup, ortalama yaş 60.75±12.28 idi. Frozen, TVS ve MRG için sonuçlar sırasıyla; sensitivite % 100/88.64/63.64, spesifite % 85.71/90.48/95.24, PPD % 93.62/95.12/96.55, NPD % 100/79.17/55.56 ve doğruluk % 95.38/89.23/73.85 olarak tespit edilmişti. Aynı zamanda myometriyal invazyon derinliğinde grade, tümör boyutu, LVSİ, P53, Ki-67 gibi faktörlerinde etkili olduğu tespit edildi. Tartışma: Endometriyum kanserli hastalarda myometriyal invazyon derinliğinin tespitinde frozen, TVS ve MRG yöntemlerini karşılaştırdık. Üç yöntem içinde Frozen sonuçları, nihai patoloji sonuçlarına en yakın yöntem olarak tespit edildi. Frozen kolay ve güvenilir bir yöntemdir. Frozen sonucuna bakılarak intraoperatif lenfadenektomi kararı alınabilir. TVS sonuçlarımızı daha önceki yapılan çalışmalardaki sonuçlara benzer veya yüksek olduğunu tespit ettik. Fakat MRG için tam tersi bir durum mevcuttu. Literatüre ve çalışmamızdaki diğer iki yönteme oranla düşük izlendi. Doğruluk oranını frozen TVS'den, TVS ise MRG'den daha yüksek olarak bulundu. Anahtar Kelimeler: Endometrium kanseri, myometriyal invazyon derinliği, magnetik rezonans görüntüleme, transvajinal ultrasonografi, frozen, nihai patoloji
Objective: The aim of this study was to investigate the efficacy levels of transvaginal ultrasonography (TVS) and magnetic resonance imaging (MRI) methods in determining the depth of myometrial invasion by comparing the results of the methods performed preoperatively with the final results of frozen section examination performed by pathologists intraoperatively. Materials and Methods: In this prospective study, preoperative TVS, MRI and intraoperative frozen section examinations were performed on 65 patients diagnosed with endometrial cancer using the diagnostic probe curettage in the Inonu University, Turgut Ozal Medical Center, Obstetrics and Gynecology Clinic between February 2017 and August 2018 to determine the depth of myometrial invasion. All three methods were evaluated by the same gynecologist, radiologist and pathologist. The results were compared with the final pathology result as the gold standard. The data were analyzed using SPSS 22.0 statistical package software. Results: Our study included 65 patients. The patients' ages were between 38 and 89 and the mean age was 60.75±12.28 years. It was found that frozen, TVS and MRI had a sensitivity of 100/88.64/63.64%, a specificity of 85.71/90.48/95.24%, a PPV (positive predictive value) of 93.62/95.12/96.55%, a NPV (negative predictive value) of 100/79.17/55.56% and an accuracy of 95.38/89.23/73.85%, respectively. At the same time, factors such as grade, tumor size, LVSI, P53, Ki-67 were also found to be effective on the depth of myometrial invasion. Discussion: We compared frozen, TVS and MRI methods to determine the depth of myometrial invasion in patients with endometrial cancer. Among three methods, the frozen results were determined to be the closest to the final pathology results. Frozen section examination is an easy and reliable method. Intraoperative lymphadenectomy decision can be made by taking the result of frozen section examination into consideration. We found that our TVS results were similar or higher than the results of previous studies. However, it was exact opposite for MRI. The results of MRI were found to be lower than the other two methods in the literature and our study. The accuracy rates were found as follows: frozen was higher than TVS and TVS was higher than MRI. Keywords: Endometrial cancer, depth of myometrial invasion, magnetic resonance imaging, transvaginal ultrasonography, frozen, final pathology
Objective: The aim of this study was to investigate the efficacy levels of transvaginal ultrasonography (TVS) and magnetic resonance imaging (MRI) methods in determining the depth of myometrial invasion by comparing the results of the methods performed preoperatively with the final results of frozen section examination performed by pathologists intraoperatively. Materials and Methods: In this prospective study, preoperative TVS, MRI and intraoperative frozen section examinations were performed on 65 patients diagnosed with endometrial cancer using the diagnostic probe curettage in the Inonu University, Turgut Ozal Medical Center, Obstetrics and Gynecology Clinic between February 2017 and August 2018 to determine the depth of myometrial invasion. All three methods were evaluated by the same gynecologist, radiologist and pathologist. The results were compared with the final pathology result as the gold standard. The data were analyzed using SPSS 22.0 statistical package software. Results: Our study included 65 patients. The patients' ages were between 38 and 89 and the mean age was 60.75±12.28 years. It was found that frozen, TVS and MRI had a sensitivity of 100/88.64/63.64%, a specificity of 85.71/90.48/95.24%, a PPV (positive predictive value) of 93.62/95.12/96.55%, a NPV (negative predictive value) of 100/79.17/55.56% and an accuracy of 95.38/89.23/73.85%, respectively. At the same time, factors such as grade, tumor size, LVSI, P53, Ki-67 were also found to be effective on the depth of myometrial invasion. Discussion: We compared frozen, TVS and MRI methods to determine the depth of myometrial invasion in patients with endometrial cancer. Among three methods, the frozen results were determined to be the closest to the final pathology results. Frozen section examination is an easy and reliable method. Intraoperative lymphadenectomy decision can be made by taking the result of frozen section examination into consideration. We found that our TVS results were similar or higher than the results of previous studies. However, it was exact opposite for MRI. The results of MRI were found to be lower than the other two methods in the literature and our study. The accuracy rates were found as follows: frozen was higher than TVS and TVS was higher than MRI. Keywords: Endometrial cancer, depth of myometrial invasion, magnetic resonance imaging, transvaginal ultrasonography, frozen, final pathology
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
