Utilidad de la histeroscopia en el diagnóstico prequirúrgico de la invasión cervical por carcinoma de endometrio

Resumen

Objetivos

Analizar el papel de la histeroscopia en nuestro centro para evaluar el grado de invasión cervical del cáncer de endometrio.

Material y mátodo

Estudio retrospectivo sobre las histeroscopias realizadas a pacientes con cáncer endometrial previamente a la cirugía. Se realiza una histeroscopia preoperatoria a 87 pacientes diagnosticadas de cáncer de endometrio entre los años 1999 y 2002. Posteriormente se contrastan los hallazgos histeroscópicos con los anatomopatológicos obtenidos de la pieza de histerectomía.

Resultados

De las 87 neoplasias estudiadas, 75 se encontraban en estadio I, 9 en estadio II y 3 en estadio III. La histeroscopia presentó concordancia con la anatomía posquirúrgica, especialmente en los estadios I y concretamente en los tumores localizados o polipoides, con un valor predictivo negativo cercano al 100%. En la detección de la afectación cervical presentó un valor predictivo positivo del 80%.

Conclusiones

La histeroscopia es un método diagnóstico útil para la detección o el descarte de invasión cervical en el cáncer de endometrio, ya que permite visualizar la cavidad uterina de forma directa y realizar biopsias dirigidas.

Abstract

Objectives

To analyze the role of hysteroscopy in the diagnosis of cervical invasion in endometrial carcinoma in our center.

Material and method

A retrospective study was conducted of hysteroscopies performed before surgery in 87 patients with endometrial carcinoma diagnosed from 1999 to 2002. Subsequently, hysteroscopic results were compared with pathological findings obtained from the hysterectomy specimens.

Material and method

A retrospective study was conducted of hysteroscopies performed before surgery in 87 patients with endometrial carcinoma diagnosed from 1999 to 2002. Subsequently, hysteroscopic results were compared with pathological findings obtained from the hysterectomy specimens.

Results

Of the 87 neoplasms studied, 75 were stage I, 9 were stage II and 3 were stage III. Hysteroscopy and pathological assessment showed close agreement, especially in stage I tumors and in pedunculated or localized tumors, with a negative predictive value of nearly 100%. The positive predictive value of hysteroscopy in the detection of cervical invasion was 80%.

Conclusions

Hysteroscopy is a useful method for assessing cervical invasion in endometrial carcinoma, as it allows direct visual inspection of the uterine cavity and guided biopsies.