Cervical cytology and pathological correlation in endometrial carcinoma

Cervical cytology and pathological correlation in endometrial carcinoma
ความสัมพันธ์ระหว่างการตรวจเซลล์วิทยาของปากมดลูกกับพยาธิสภาพของมะเร็งเยื่อบุโพรง มดลูก

Rakchai Buhachat, D. of Obstetric and Gynecology, F. of Medicine, PSU.
Virach Wootipum, Asst. Prof., D. of Obstetric and Gynecology, F. of Medicine, PSU.
Corresponding e-mail : brakchai@ratree.psu.ac.th

Presented : The 16th Annual Academic Meeting, Faculty of Medicine, PSU, Hat Yai, Songkhla, 16-18 August 2000
Key words : cervical cytology, pathological correlation, endometrial carcinoma

Introduction : Since FIGO suggest that the staging of endometrial carcinoma require surgical laparotomy, the increased cases need for preoperative staging are more remarkable. Many known poor prognostic factors were evaluated to meet the criteria for full surgical staging including pelvic or paraaortic lymphadenectomy in the high risk patients.

Objective : The aim of the study was to determine the malignant or dysplastic cervical cytology in the preoperative evaluation with the other poor prognostic factors in endometrial carcinoma.

Method : We collected endometrial carcinoma from 1992 to 1998 and reviewed for demographic data and preoperative cervical cytology. The patients were performed surgical exploration to assess the malignant extension. The correlation between cervical cytology and pathologic finding were evaluated.

Results : Seventy nine patients were recruited in this study. The mean age was 53 years old and 58 (73.4%) patients were menopause. Fifty five (72.2%) patients had normal or inflammatory cervical smear and twenty two (27.8%) patients had positive malignant or dysplastic smear in the preoperative 6 month periods. The abnormal cervical smears were statistically significance in the correlation with deep myometrial invasion (OR 7.3, 95% CI 2.5-21.2), adnexal involvement (OR 3.9, 95%CI 1.2-13.1), cervical extension (OR 8.7, 95%CI 2.6-28.9), malignant grad (OR 4.9, 95%CI 1.7-13.8) and FIGO staging (OR 28, 95%CI 6.4- 200). In the multiple logistic regression analysis, only FIGO stage was statistically associated with abnormal cervical cytology (adjusted OR 11.4, 95%CI 1.4-94.2).

Conclusion : Cervical cytology should be a part of the preoperative endometrial carcinoma evaluation. The patients with abnormal cervical cytology should aware gynecologist to perform com-plete surgical staging.

BACK