B. Lampe et al., ACCURACY OF PREOPERATIVE HISTOLOGY AND MACROSCOPIC ASSESSMENT OF CERVICAL INVOLVEMENT IN ENDOMETRIAL CARCINOMA, European journal of obstetrics, gynecology, and reproductive biology, 74(2), 1997, pp. 205-209
Objective: To compare the diagnostic accuracy between the preoperative
ly and macroscopically established determination of cervical involveme
nt in endometrial carcinoma. Study design: During the period 1987 to 1
991, 154 patients with endometrial cancer were evaluated in a retrospe
ctive blind manner with the objective of assessing the diagnostic accu
racy of the preoperative (prehysterectomy curettage) and the macroscop
ic (sectioned surgical specimen) determination of the involvement of t
he cervix. The results were compared with the histological findings of
the hysterectomy specimen (gold standard). Results: Preoperative pre-
hysterectomy curettage established a sensitivity of 38% and a specific
ity of 91% whereas the macroscopic findings (gross appearance) confirm
ed a sensitivity of 50% and a specificity of 95%. A prevalence of 17%
for cervical involvement was found. In patients with cervical involvem
ent diagnosed on pre-hysterectomy curettage, a positive predictive val
ue of 45% and negative predictive value of 88% were established. A pos
itive predictive value of 68% and a negative predictive value of 90% r
esulted from the judgement of the cervical gross appearance. Conclusio
ns: We conclude that the cervical involvement of endometrial carcinoma
diagnosed on pre-hysterectomy tissue is less predictive than the judg
ement of the intraoperative gross appearance of the cervix. (C) 1997 E
lsevier Science Ireland Ltd.