OBJECTIVE: This study aimed to determine the accuracy of internal examination and ultrasound in early stage cervical cancer. Specific objectives were to determine the accuracy of internal examination and sonography in measuring tumor size and the accuracy of sonography in detecting vaginal involvement, stromal invasion, parametrial and lymph node involvement by comparing them with the surgicopathologic findings.
MATERIALS AND METHODS: 35 patients diagnosed with early stage cervical cancer for radical hysterectomy with bilateral salpingooophorectomy were recruited. Presence of poor prognostic factors was determined by internal examination and sonography and compared with the surgicopathologic result.
RESULTS: Ultrasound and internal examination have an accuracy of 74% and 68%, respectively. Ultrasound accuracy in detecting more than one third stromal invasion is 68%, vaginal involvement is 85%, parametrial involvement is 92% and lymph node involvement is 100%.
CONCLUSION: Ultrasound can be recommended as an adjunct to internal examination in the preoperative assessment of early stage cervical cancer.

Human ; Female ; Middle Aged ; Adult ; Uterine Cervical Neoplasms ; Prognosis ; Hysterectomy ; Ultrasonography ; Vagina ; Lymph Nodes

This study aimed to determine the utility of post-evacuation transvaginal ultrasound as an adjunct to serum ß-hCG monitoring of patients diagnosed with hydatidiform mole. It is a prospective cohort analysis of 13 patients diagnosed with hydatidiform mole who underwent suction curettage from December 1, 2010 to February 28, 2011 at the Philippine General Hospital. Transvaginal ultrasound immediately post-evacuation of hydatidiform mole and then monthly thereafter were performed. The morphologic characteristics of the uterus and ovaries were observed and recorded during each examination. The usual monitoring protocol of hydatidiform mole after evacuation of molar products which is serial serum ß-hCG was observed. The serum ß-hCGlevels and the results of the transvaginal ultrasound scans were correlated during data analysis.
Data were analyzed using STATCALC version 2000.Traditional calculations for the sensitivity, specificity, positive and negative predictive values for each sonographic descriptor was conduced with their 95% confidence intervals derived. All P-values less than .05 were considered statistically significant.
Two of the 13 (15.4%) patients with complete hydatidiform mole progressed to gestational trophoblastic neoplasia (GTN).In this study, the presence of uterine mass with increased vascularity and low resistance indices on color Doppler studies was the most accurate in predicting the progression of hydatidiform mole to GTN with a high specificity (90.9%)and sensitivity (100%).Interestingly, the uterine mass was noted even before the rise in the serum ß-hCG levels. The other sonographic features observed post-evacuation of hydatidiform mole include: dilated arcuate vessels, theca lutein cysts and hematometra.
This study demonstrated that transvaginal ultrasound is essential in the diagnosis of hydatidiform mole as well as as in the follow-up of patients post-evacuation of molar tissues and in predicting the degeneration of hydatidiform mole to GTN. Clinical use of its predictive value permits individualization of follow-up and a timely and appropriate management or referral of patients for treatment prior to the onset of advanced stage of disease.

Human ; Female ; Adult ; Hematometra ; Lutein ; Vacuum Curettage ; Ovary ; Hospitals, General ; Philippines ; Hydatidiform Mole ; Gestational Trophoblastic Disease ; Molar ; Cysts