title: Early-stage cervical cancer: agreement between ultrasound and histopathological findings with regard to tumor size and extent of local disease.
abstract: OBJECTIVE
  To determine the agreement between ultrasound and histological examination of the cervix in patients with early stage cervical cancer with regard to tumor size and local extent of the disease.
  
  
  METHODS
  Eighteen patients with histologically proven cervical cancer Stage IB1-IIA according to traditional clinical staging (FIGO 1988) who were scheduled for radical surgery underwent a standardized transvaginal ultrasound examination. The maximum tumor length, anteroposterior tumor diameter, tumor width, tumor area, depth of cervical stroma invasion, and the minimal thickness of tumor-free cervical stroma on sagittal and transverse planes through the cervix were measured, and the local extent of the disease within the parametria and vagina were evaluated. The surgical specimens were examined using a specifically devised method of histopathological examination. The results of the ultrasound and histopathological examinations were compared.
  
  
  RESULTS
  Limits of agreement were wide and the intraclass correlation coefficient (ICC) was low (0.51-0.58) for three of the four measurements taken to represent the minimal depth of tumor-free cervical stroma, i.e. the results of the measurements taken posteriorly and laterally. However, the limits of agreement were narrower and the ICC values were higher (0.74-0.92) for the depth of cervical stroma invasion and for the tumor size measurements. Histological examination revealed parametrial cancer infiltration in four patients, which was detected during ultrasound examination, with no false-positive results.
  
  
  CONCLUSIONS
  Transvaginal sonography is acceptably accurate for evaluation of tumor size and depth of cervical stroma invasion in clinical practice.
authors.affiliation: Department of Obstetrics and Gynecology, Lithuanian University of Health Sciences, Kaunas, Lithuania. agaurilcikas@mac.com
authors.forename: A
authors.initials: A
authors.lastname: Gaurilcikas
authors.forename: D
authors.initials: D
authors.lastname: Vaitkiene
authors.forename: A
authors.initials: A
authors.lastname: Cizauskas
authors.forename: A
authors.initials: A
authors.lastname: Inciura
authors.forename: E
authors.initials: E
authors.lastname: Svedas
authors.forename: R
authors.initials: R
authors.lastname: Maciuleviciene
authors.forename: A
authors.initials: A
authors.lastname: Di Legge
authors.forename: G
authors.initials: G
authors.lastname: Ferrandina
authors.forename: A C
authors.initials: AC
authors.lastname: Testa
authors.forename: L
authors.initials: L
authors.lastname: Valentin
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology*; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D011446:Prospective Studies; D014463:Ultrasonography; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*