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Transcervical needle biopsy for the differential diagnosis between uterine sarcoma and leiomyoma
- Source :
- Cancer. 94:1713-1720
- Publication Year :
- 2002
- Publisher :
- Wiley, 2002.
-
Abstract
- BACKGROUND The clinical differential diagnosis between uterine sarcoma and benign leiomyoma is difficult even with magnetic resonance imaging (MRI). Therefore, a considerable number of patients have undergone hysterectomies due to an indication of “suspected malignancy” based on tumor size alone. However, approximately 80% of these hysterectomies have been judged to have been recommended inappropriately. In such situations, reliable preoperative diagnostic tests are required. The authors have evaluated the accuracy of needle biopsy for uterine myoma-like tumors, a procedure that to the authors' knowledge has been performed infrequently. METHODS Transcervical needle biopsy was performed in 435 patients with uterine myoma-like tumors. The biopsy specimens were scored for degree of malignancy according to the histopathologic criteria proposed by Bell et al. Histopathologic evaluation of surgical specimens and clinical outcome after 2 years of follow-up were used as the reference standards. RESULTS Of 435 patients, 7 had uterine sarcomas, 4 of which were scored as ≥ 4 points and were diagnosed as “sarcoma” by needle biopsy alone. No sarcoma cases were included in the group of patients with a score of 0. The cutoff score combining the highest sensitivity and specificity with respect to distinguishing uterine leiomyosarcoma from uterine leiomyoma was 2; sensitivity, specificity, and positive and negative predictive values were 100%, 98.6%, 58%, and 100.0%, respectively. CONCLUSIONS Transcervical needle biopsy using histopathologic scoring is a reliable diagnostic test for the differential diagnosis between uterine sarcoma and leiomyoma. This diagnostic method, combined with MRI screening, could reduce the number of patients currently undergoing unnecessary surgery. Cancer 2002;94:1713–20. © 2002 American Cancer Society. DOI 10.1002/cncr.10382
- Subjects :
- Adult
Leiomyosarcoma
Cancer Research
medicine.medical_specialty
Cervix Uteri
Sensitivity and Specificity
Reference Values
Biopsy
medicine
Humans
False Positive Reactions
False Negative Reactions
Uterine Neoplasm
Aged
Uterine leiomyoma
Leiomyoma
medicine.diagnostic_test
Uterine sarcoma
business.industry
Biopsy, Needle
Sarcoma
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Surgery
Oncology
Uterine Neoplasms
Female
Differential diagnosis
business
Subjects
Details
- ISSN :
- 10970142 and 0008543X
- Volume :
- 94
- Database :
- OpenAIRE
- Journal :
- Cancer
- Accession number :
- edsair.doi.dedup.....3a9396dd7000c0a3d22051f0bf70f69f
- Full Text :
- https://doi.org/10.1002/cncr.10382