Tags

Type your tag names separated by a space and hit enter

[Preliminary study of the clinical value of colposcopy in diagnosing vagina invasion in cervical cancer].
Zhonghua Fu Chan Ke Za Zhi. 2020 May 25; 55(5):322-326.ZF

Abstract

Objective:

To explore the preliminary clinical values of colposcopy in the diagnosis of vaginal invasion in cervical cancer.

Methods:

A retrospective review of the clinical records of patients (31 cases) with cervical cancer treated in Xuzhou Cancer Hospital from April 2015 to August 2019. For those with early-stage cervical cancer and the vagina invasion being difficult to be determined, those with advanced cervical cancer and the scope of vaginal invasion being difficult to be judged, and those with obvious vaginal tumor and underexposed cervix or inconspicuous cervical lesion and the primary location needing to be identified, colposcopy-guided vaginal and cervix biopsy were performed before treatment.

Results:

(1) Image characteristics of colposcopy and pathological diagnosis: among 31 cases, 30 of them had the similar images of vagina and cervix. The images were dense acetowhite and (or) thick mosaic, coarse punctate and atypical vessels. Lugol's staining was uniformly bright yellow or brown. Pathological biopsy of vaginal wall: 27 cases were metastatic carcinoma, 3 cases were vaginal intraepithelial neoplasia (VaIN) Ⅱ-Ⅲ. One case showed dense acetowhite epithelium and atypical vessels image in cervix and thin acetowhite epithelium in upper 1/3 vagina which disappeared in two minutes; the results of vaginal biopsy was chronic inflammation. (2) Vaginal invasion diagnosed by colposcopy: among 31 cases, 14 of them without invasion of uterine side, vaginal invasion was judged as followed by colposcopy, being consistent with biopsy: 1 case of chronic vaginitis, 2 cases VaINⅡ, 1 case VaINⅢ, 6 cases upper 1/3 vagina invasion, 4 cases lower 1/3 vagina invasion. Among 10 cases with invasion of uterine side, vaginal invasion were identified by colposcopy, being consistent with biopsy: 4 cases upper 1/3 vagina invasion and 6 cases upper 1/2 vagina invasion. Five cases who had clinical diagnosis of vaginal cancer were diagnosed as cervical cancer with vaginal invasion by colposcopy, being consistent with biopsy. Two cases with no obvious lesions of cervix and vagina were diagnosed as cervical cancer with vaginal invasion by colposcopy, being consistent with cervical and vaginal biopsy: 1 case with stage Ⅳ (transfer to the left supraclavicular lymph node) and 1 case with stage Ⅱ a1.

Conclusions:

Colposcopy and multi-point biopsy have complementary diagnostic value for the cervical cancer cases that the invasion and scope of vagina are difficult to be determined by physical examination and (or) imaging examination. Thus the range of vaginal resection for patients underwent operation and the lower boundary of pelvic radiation field for those underwent radiotherapy could be fixed, so as to make the treatment much more individualized and humanized; the indications need further discussion.

Authors+Show Affiliations

Department of Gynecologic Oncology, Xuzhou Hospital Affiliated to Jiangsu University/Xuzhou Cancer Hospital, Xuzhou 221000, China.Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100021, China.Department of Gynecologic Oncology, Xuzhou Hospital Affiliated to Jiangsu University/Xuzhou Cancer Hospital, Xuzhou 221000, China.Department of Gynecologic Oncology, Xuzhou Hospital Affiliated to Jiangsu University/Xuzhou Cancer Hospital, Xuzhou 221000, China.Department of Gynecologic Oncology, Xuzhou Hospital Affiliated to Jiangsu University/Xuzhou Cancer Hospital, Xuzhou 221000, China.Department of Gynecologic Oncology, Xuzhou Hospital Affiliated to Jiangsu University/Xuzhou Cancer Hospital, Xuzhou 221000, China.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

32464720

Citation

Zhu, Y L., et al. "[Preliminary Study of the Clinical Value of Colposcopy in Diagnosing Vagina Invasion in Cervical Cancer]." Zhonghua Fu Chan Ke Za Zhi, vol. 55, no. 5, 2020, pp. 322-326.
Zhu YL, Zhang WH, Liu BB, et al. [Preliminary study of the clinical value of colposcopy in diagnosing vagina invasion in cervical cancer]. Zhonghua Fu Chan Ke Za Zhi. 2020;55(5):322-326.
Zhu, Y. L., Zhang, W. H., Liu, B. B., Zhang, P., Zhang, J., & Wang, L. (2020). [Preliminary study of the clinical value of colposcopy in diagnosing vagina invasion in cervical cancer]. Zhonghua Fu Chan Ke Za Zhi, 55(5), 322-326. https://doi.org/10.3760/cma.j.cn112141-20200211-00093
Zhu YL, et al. [Preliminary Study of the Clinical Value of Colposcopy in Diagnosing Vagina Invasion in Cervical Cancer]. Zhonghua Fu Chan Ke Za Zhi. 2020 May 25;55(5):322-326. PubMed PMID: 32464720.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Preliminary study of the clinical value of colposcopy in diagnosing vagina invasion in cervical cancer]. AU - Zhu,Y L, AU - Zhang,W H, AU - Liu,B B, AU - Zhang,P, AU - Zhang,J, AU - Wang,L, PY - 2020/5/29/entrez PY - 2020/5/30/pubmed PY - 2020/6/9/medline KW - Colposcopy KW - Neoplasm invasiveness KW - Uterine cervical neoplasms KW - Vaginal neoplasms SP - 322 EP - 326 JF - Zhonghua fu chan ke za zhi JO - Zhonghua Fu Chan Ke Za Zhi VL - 55 IS - 5 N2 - Objective: To explore the preliminary clinical values of colposcopy in the diagnosis of vaginal invasion in cervical cancer. Methods: A retrospective review of the clinical records of patients (31 cases) with cervical cancer treated in Xuzhou Cancer Hospital from April 2015 to August 2019. For those with early-stage cervical cancer and the vagina invasion being difficult to be determined, those with advanced cervical cancer and the scope of vaginal invasion being difficult to be judged, and those with obvious vaginal tumor and underexposed cervix or inconspicuous cervical lesion and the primary location needing to be identified, colposcopy-guided vaginal and cervix biopsy were performed before treatment. Results: (1) Image characteristics of colposcopy and pathological diagnosis: among 31 cases, 30 of them had the similar images of vagina and cervix. The images were dense acetowhite and (or) thick mosaic, coarse punctate and atypical vessels. Lugol's staining was uniformly bright yellow or brown. Pathological biopsy of vaginal wall: 27 cases were metastatic carcinoma, 3 cases were vaginal intraepithelial neoplasia (VaIN) Ⅱ-Ⅲ. One case showed dense acetowhite epithelium and atypical vessels image in cervix and thin acetowhite epithelium in upper 1/3 vagina which disappeared in two minutes; the results of vaginal biopsy was chronic inflammation. (2) Vaginal invasion diagnosed by colposcopy: among 31 cases, 14 of them without invasion of uterine side, vaginal invasion was judged as followed by colposcopy, being consistent with biopsy: 1 case of chronic vaginitis, 2 cases VaINⅡ, 1 case VaINⅢ, 6 cases upper 1/3 vagina invasion, 4 cases lower 1/3 vagina invasion. Among 10 cases with invasion of uterine side, vaginal invasion were identified by colposcopy, being consistent with biopsy: 4 cases upper 1/3 vagina invasion and 6 cases upper 1/2 vagina invasion. Five cases who had clinical diagnosis of vaginal cancer were diagnosed as cervical cancer with vaginal invasion by colposcopy, being consistent with biopsy. Two cases with no obvious lesions of cervix and vagina were diagnosed as cervical cancer with vaginal invasion by colposcopy, being consistent with cervical and vaginal biopsy: 1 case with stage Ⅳ (transfer to the left supraclavicular lymph node) and 1 case with stage Ⅱ a1. Conclusions: Colposcopy and multi-point biopsy have complementary diagnostic value for the cervical cancer cases that the invasion and scope of vagina are difficult to be determined by physical examination and (or) imaging examination. Thus the range of vaginal resection for patients underwent operation and the lower boundary of pelvic radiation field for those underwent radiotherapy could be fixed, so as to make the treatment much more individualized and humanized; the indications need further discussion. SN - 0529-567X UR - https://www.unboundmedicine.com/medline/citation/32464720/[Preliminary_study_of_the_clinical_value_of_colposcopy_in_diagnosing_vagina_invasion_in_cervical_cancer] L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&DOI=10.3760/cma.j.cn112141-20200211-00093 DB - PRIME DP - Unbound Medicine ER -